scholarly journals PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report

2021 ◽  
Vol 28 (6) ◽  
pp. 4577-4586
Author(s):  
Guangchao Wei ◽  
Fuxin Guo ◽  
Ang Qu ◽  
Weijuan Jiang ◽  
Yuliang Jiang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Partial Response ◽  
Checkpoint Inhibitors ◽  
Organs At Risk ◽  
Recurrence Rates ◽  
Recurrent Cervical Cancer ◽  
Seed Implantation ◽  
Normal Tissues ◽  
Gynecology And Obstetrics ◽  
Choice Of Treatment

Cervical cancer is the fourth most common cancer in females worldwide. Patients with stage III and IV cervical cancer based on the Federation of Gynecology and Obstetrics (FIGO) classification have higher recurrence rates. Because of organs at risk (OAR) protection and the low indication rate of salvage surgery, the choice of treatment is always challenging. Systemic chemotherapy is palliative and can be performed in conjunction with surgery or radiotherapy; however, it has no significant benefit to survival. Brachytherapy and stereotactic body radiotherapy (SBRT) are characterized by extremely high radiation doses applied to tumor cells while sparing the normal tissues. Several studies have investigated the efficacy of these technologies in recurrent cervical cancer and showed promising results. The immune checkpoint inhibitors approach was also investigated and showed promising results too. Herein, we report a case of a patient with cervical cancer that recurred five months after adjuvant chemotherapy and concurrent chemoradiotherapy. The disease prognosis after interstitial implantation brachytherapy (IIB) was determined. Then, the patient underwent radioactive 125I-seed implantation combined with PD-1 inhibitor treatment. The patient exhibited a partial response after seed implantation, and up to now, the duration of this partial response was 24 months.

scholarly journals Chinese Expert Consensus on Iodine125 Seed Implantation for Recurrent Cervical Cancer in 2021

2021 ◽  
Vol 11 ◽  
Author(s):  
Ping Jiang ◽  
Lijuan Zou ◽  
Lichun Wei ◽  
Guanghui Cheng ◽  
Baosheng Sun ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Performance Status ◽  
Three Dimensional ◽  
Pelvic Recurrence ◽  
Planning System ◽  
Treatment Planning System ◽  
Recurrent Cervical Cancer ◽  
Efficient Treatment ◽  
Seed Implantation ◽  
Poor Seed

The treatment modality for recurrent cervical cancer (rCC) is limited, and the prognosis of these patients is poor. Seed implantation could be an important component of rCC management in the context of dose boost or salvage therapy after surgery or radiotherapy, which is characterized by a minimally invasive, high local dose, and rapidly does fall, sparing normal tissue. For patients with good performance status and lateral pelvic wall recurrence with an available puncture path, seed implantation was recommended, as well as for selected central pelvic recurrence and extra-pelvic recurrence. The combination of brachytherapy treatment planning system and CT guidance was needed, and three-dimensional printing templates could greatly improve the accuracy, efficiency, and quality of seed implantation to achieve a potential ablative effect and provide an efficient treatment for rCC. However, the recommendations of seed implantation were mainly based on retrospective articles and lack high-quality evidence, and multicenter prospective randomized studies are needed. In this consensus on iodine125 seed implantation for rCC, indication selection, technical process and requirements, dosimetry criteria, radiation protection, combined systemic therapy, and outcomes of seed implantation for rCC are discussed.

scholarly journals High TRIM44 expression as a valuable biomarker for diagnosis and prognosis in cervical cancer

2019 ◽  
Vol 39 (3) ◽  
Author(s):  
Shuang Liu ◽  
Fanling Meng ◽  
Jing Ding ◽  
Hongying Ji ◽  
Mu Lin ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Clinical Significance ◽  
Poor Prognosis ◽  
Malignant Tumors ◽  
Histological Grade ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Normal Tissues ◽  
Diagnosis And Prognosis ◽  
Gynecology And Obstetrics

Abstract Tripartite motif containing 44 (TRIM44) has been reported to be up-regulated in multiple aggressive malignant tumors. However, its expression status and clinical significance in cervical cancer remain unknown. The purpose of this study was to investigate the clinical significance of TRIM44 expression and the prognosis in patients with cervical cancer (CC). Fresh frozen tissues from 5 samples of CC and 4 normal cervical tissues were analyzed for TRIM44 expression using RT- PCR and Western blot analysis. 122 paraffin-embedded surgical specimens from patients with CC were collected for an immunohistochemistry. TRIM44 expression was found to be significantly up-regulated in cervical cancer specimens compared with adjacent normal tissues (P<0.001). Statistical analysis showed that TRIM44 expression was significantly correlated with the International Federation of Gynecology and Obstetrics (FIGO) stage, histological grade and lymph node metastasis, but not with age, histological type, and tumor size. Kaplan–Meier survival analysis suggested that high TRIM44 expression was associated with poor prognosis. Patients highly expressing TRIM44 have significantly shorter overall survival (OS) (P=0.006) and disease-free survival (DFS) (P=0.002). Furthermore, multivariate Cox analysis showed TRIM44 was an independent risk factor for poor prognosis. Our study demonstrated that TRIM44 expression contributes to the progression of cervical cancer, and could be used as a marker of clinical diagnosis and prognosis of patients with cervical cancer.

scholarly journals Radioactive 125I Seed Implantation for Recurrent Cervical Carcinoma After Surgery and Radiotherapy: A Case Report

2021 ◽  
Author(s):  
Shiqi Qiao ◽  
Hongtao Zhang ◽  
Xuemin Di ◽  
JinXin Zhao ◽  
Juan Wang
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Radical Hysterectomy ◽  
125I Seed ◽  
Retroperitoneal Lymph Node ◽  
Recurrent Cervical Cancer ◽  
Seed Implantation ◽  
Node Metastasis ◽  
125I Seed Implantation

Abstract Background: The prognosis of cervical cancer is remarkable, but there are still instances of pelvic and/or extrapelvic recurrence after radical hysterectomy with platinum-based chemoradiotherapy. Sixty percent of the patients with radiotherapy (RT) failure have pelvic recurrence, and 80% of them relapse within two years after treatment. Recurrent cervical cancer seriously affects the prognosis and survival rate of patients. Due to the dose limitation for normal tissue, it is difficult to deliver a sufficient number of doses to recurrent lesions through reirradiation. With the rapid development of brachytherapy technologies such as three-dimensional afterloading brachytherapy, interstitial brachytherapy and radioactive 125I seed implantation, the overall survival (OS) of patients with recurrent cervical cancer has been improving. In the present study, a case in which the patient was successfully treated with radioactive 125I seed implantation is reported.Case presentation: The patient, a 47-year-old woman, was initially diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer and received preoperative radiotherapy, radical hysterectomy, pelvic lymph node dissection and postoperative radiotherapy. After 95 months of follow-up, retroperitoneal lymph node metastasis and edema of the left lower limb . The size of the retroperitoneal lesion was 2.3 × 2.0 cm, and the size of the left supraclavicle lesion was 2.0 × 1.5 cm. Radioactive 125I seed implantation was performed for retroperitoneal lymph node metastasis and left supraclavicular metastasis. Paclitaxel and cisplatin chemotherapy were given after the operation. Three months after implantation, the size of the retroperitoneal focus was 1.5 × 1.1 cm, and the size of the left supraclavicular lesion was 1.0 × 0.6 cm. Thirteen months after implantation, according to the RECIST standard, the therapeutic effect reached CR. At the time of submission, the patient's progression-free survival was 6 years and 4 months.Conclusions: CT-guided 125I seed implantation is a safe, effective, and minimally invasive method for treating patients with recurrent cervical cancer after radiotherapy. The response of this patient indicates that 125I seed implantation can be used as a complementary treatment for recurrent cervical cancer after chemoradiotherapy and may also prove to be reliable for comprehensive treatment of cervical cancer.

scholarly journals The Belarus Experience of Pelvic Artery Embolisation in Patients with Advanced and Recurrent Cervical Cancer Presenting with Haemorrhage

2018 ◽  
Vol 14 (1) ◽  
pp. 45
Author(s):  
Olga P Matylevich ◽  
Vladimir V Akinfeev ◽  
Thomas C Randall ◽  
Kathleen M Schmeler ◽  
Oleg G Sukonko
Keyword(s):  
Cervical Cancer ◽  
Recurrent Disease ◽  
Locally Advanced ◽  
Primary Treatment ◽  
Recurrent Cervical Cancer ◽  
Gynecology And Obstetrics ◽  
Antineoplastic Treatment ◽  
Pelvic Artery ◽  
Invasive Intervention

To determine the efficacy of pelvic artery embolisation (PAE) in patients with locally advanced and recurrent cervical cancer (CC) complicated by haemorrhage, a retrospective study was performed of 81 patients with locally advanced or recurrent CC who underwent PAE for haemorrhage. Of the 81 patients included in the study, 68 (84%) had primary locally advanced CC and 13 (16%) had recurrent disease. Distribution of patients with primary disease according to the International Federation of Gynecology and Obstetrics (FIGO) stages was: IIB (n=4, 6%), IIIB (n=44, 65%), IV (n=20, 29%). The PAE controlled the haemorrhage in 76 patients (94%). After successful embolisation, 46 of 68 (68%) patients with primary CC started antineoplastic treatment a median of 3 days (range 1–17 days) after treatment. Twenty-nine of these women (43%) subsequently completed primary treatment for their disease. During the follow-up period, 67 patients (83%) died of disease and 4 (5%) died of other causes. The adjusted 1-year survival was 41.4% (standard error [SE] 5.6%), 5-year survival was 17.9% (SE 4.5%), and median adjusted survival was 8.4 months. Survival of the 22 patients (32%) who did not receive further treatment and 46 patients (68%) who continued the treatment was significantly different, with a 1-year adjusted survival of 15.2% (SE 8.1%) and 53.5% (SE 7.4%) respectively. None of the patients who did not receive further treatment survived 5 years, whereas in the group undergoing further treatment, the 5-year adjusted survival was 24.0% (SE 6.8%) and the median adjusted survival was 5.4 months and 12.8 months, respectively (p<0.001). Pelvic artery embolisation was effective in controlling haemorrhage in 94% of patients with locally advanced and recurrent CC. Sixty-eight percent of patients were able to undergo further antitumor treatment. Pelvic artery embolisation is a minimally invasive intervention that can be effective at any stage of treatment in patients with CC presenting with haemorrhage.

125 I Seed Implantation in the Treatment of 3 Cases of Recurrent Cervical Cancer

Brachytherapy ◽  
2017 ◽  
Vol 16 (3) ◽  
pp. S70
Author(s):  
Yongbing Xu ◽  
Aixia Sui ◽  
Yitong Li ◽  
Hongtao Zhang ◽  
Juan Wang
Keyword(s):  
Cervical Cancer ◽  
Recurrent Cervical Cancer ◽  
Seed Implantation

CT and Template-Guided 125I Seed Implantation on Pelvic Recurrent Cervical Cancer

Brachytherapy ◽  
2019 ◽  
Vol 18 (3) ◽  
pp. S13-S14
Author(s):  
Bin Huo ◽  
Xiaodong Huo ◽  
Haitao Wang ◽  
Lei Wang
Keyword(s):  
Cervical Cancer ◽  
125I Seed ◽  
Recurrent Cervical Cancer ◽  
Seed Implantation ◽  
125I Seed Implantation

COMPARATIVE STUDY IN BETWEEN INTRALESIONAL VITAMIN D3 AND INTRALESIONAL BLEOMYCIN IN THE TREATMENT OF CUTANEOUS VERRUCAE

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Shrikant . ◽  
R.D. Mehta ◽  
B.C. Ghiya
Keyword(s):  
Partial Response ◽  
Comparative Study ◽  
Recurrence Rate ◽  
Vitamin D3 ◽  
Complete Response ◽  
Recurrence Rates ◽  
Additional Advantage ◽  
Cost Effective Treatment ◽  
Group A ◽  
Group B

Background: Verruca is one of the common dermatopathologies which has multiple therapeutic options but with variable success rates, refractory cases and high recurrence rates. Nowadays, treatment with intralesional injections has gained recognition due to its effectiveness in clearing verrucae. These act by stimulating the cell-mediated immunity. Out of scores of options available for intralesional therapeutics, Vitamin D3 appears to be more promising but least evaluated. Therefore, we planned to evaluate the efficacy of intralesional Vitamin D3 in various types of cutaneous verrucae. Simultaneously the results were compared with intralesional bleomycin, also. Methods: A total of 200 patients of cutaneous verrucae with varying size and duration were included in the experimental randomized comparative study. We divided them into two groups. Group A, comprising of 100 patients, received 0.2-0.5 ml intralesional Vitamin D3 (600,000 IU, 15mg/ml) and Group B, also of hundred subjects, received intralesional Bleomycin (1 mg/ml) into the base of verrucae. A maximum of 5 verrucae were injected per session at 3 weeks interval until resolution or for a maximum of 4 sessions. Patients were followed up for 6 months after the last injection to assess the clearance status and detect any recurrence. Results: In Group A (Vitamin D3), 'Complete response', 'Partial response' and 'No response' were observed in 85.07%, 6.74% and 8.17% respectively after 4 sessions. Recurrence rate was 0.81% after 6 months. In Group B (Bleomycin), 'Complete response', 'Partial response' and 'No response' were found in 77.99%, 10.47% and 11.53% in the series. Recurrence rate was 1.71%, comparatively higher in group B. Conclusion: The efficacy of intralesional Vitamin D3 was found significantly higher as compared to intralesional Bleomycin in the treatment of cutaneous verrucae with less recurrence rates. Vitamin D3 has an additional advantage of cost-effective treatment over Bleomycin. We purpose its use, as a primary mode of treatment in various types of cutaneous verrucae. Keywords: Bleomycin, Vitamin D3, Verrucae.

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