A PROSPECTIVE RANDOMIZED STUDY TO COMPARE THE CONCURRENT CHEMO-RADIATION VERSUS HYPO-FRACTIONATED CHEMO-RADIATION IN LOCALLY ADVANCED CERVICAL CANCER.

2021 ◽  
pp. 40-42
Author(s):  
Arpan Jana ◽  
Pabitra Das ◽  
Poulami Gupta ◽  
Phalguni Gupta
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Intracavitary Brachytherapy ◽  
External Beam ◽  
Carcinoma Cervix ◽  
Advanced Carcinoma

Background: Concurrent chemo-radiation is the standard treatment worldwide for locally advanced squamous Cell carcinoma cervix. However, conventional chemo-radiotherapy is also associated with unacceptable local and systemic failure rates for locally advanced disease. Biologically squamous cell carcinoma of head- neck cancer and cervical cancer behaves quite similarly in response to radiotherapy. So, it can be expected that, altered fractionation can increase the local control in case of squamous cell carcinoma cervix than conventional radiotherapy. There is no randomised control trial for carcinoma cervix till date, which compares conventional chemo-radiation with hypo-fractionated chemo-radiation. Aims And Objectives: The present study was planned to compare local disease control and acute toxicity of conventional chemo-radiation with hypo-fractionated chemo-radiation in locally advanced carcinoma cervix. Materials And Methods: In Conventional Chemo-radiation Arm A patients (n=30) received external beam radiotherapy 50 Gy in 25 fractions in 5 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 7 Gy per fraction once in a week for 3 weeks. The second group of hypo-fractionated Arm B received external beam radiotherapy 45 Gy in 20 fractions in 4 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 9 Gy per fraction once in a week for 2 weeks. Results: Grade II diarrhea were seen more in Arm B 17 (56.66%) compare to Arm A 12(40%) and grade III diarrhea was seen 4 (3.33%) in Arm B and 2(6.66%) in Arm A. At 2 months and 6 months after completion of treatment Complete response were 25 (83.4%) in Arm A compare to 22 (73.3%) in Arm B and 20 (74.1%) in Arm A and 18 (72%) in Arm B respectively. Conclusion: Hypo-fractioned radiotherapy may be used as an alternate protocol for treatment of locally advanced carcinoma cervix with acceptable toxicities.

Expression of immune cell markers and tumor markers in patients with cervical cancer

2020 ◽  
Vol 30 (7) ◽  
pp. 969-974
Author(s):  
Liming Zhang ◽  
Hui Zhang ◽  
Yuheng Huang ◽  
Xiaowei Xi ◽  
Yunyan Sun
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Carcinoembryonic Antigen ◽  
Tumor Markers ◽  
Squamous Cell ◽  
Early Stage ◽  
Locally Advanced ◽  
Control Group ◽  
Healthy Women

ObjectiveCervical cancer is one of the most common cancers worldwide, and immune function may impact disease progression. Serum markers may also be associated with diagnosis and progression. The aim of this study was to explore the clinical usefulness of determining the levels of peripheral blood immune cells and serum tumor markers in predicting diagnosis and prognosis of patients with cervical cancer.Methods82 patients with cervical cancer (early stage group: IA–IB1 and IIA1; locally advanced group: IB2 and IIA2), 54 patients with cervical intra-epithelial neoplasia (CIN), and 54 healthy women (control group) were recruited. Inclusion criteria were: (1) patients whose cervical lesions were determined based on biopsy; and (2) patients who had not undergone immunotherapy, chemotherapy, or radiotherapy. The exclusion criteria were as follows: (1) patients with a history of other malignant tumors; (2) patients with heart, kidney, and other organ failure; (3) patients with immune diseases; and (4) pregnant or lactating women. The levels of immunocytes and tumor markers were assayed. The relationships among histopathologic factors were analyzed. The correlation between the levels of immunocytes and tumor markers in patients with different degrees of cervical lesions (pre-invasive or cancer) and healthy women was evaluated.ResultsThe squamous cell carcinoma antigen and carcinoembryonic antigen levels in the control group and the CIN group were significantly lower than those in the cervical cancer groups (p<0.01). The incidence of lymph node metastasis in the early stage and locally advanced groups were 22.9% (11/48) and 46.2% (12/26), respectively, and 58.8% (20/34) and 7.5% (3/37) in the positive and negative lymphovascular invasion groups, respectively (p<0.05). The levels of CD8+ and CD8+ CD28+ T cells in the early stage group were markedly lower than those in the CIN group and the control group (p=0.014, p=0.008, respectively). The ratio of CD4+CD25+/CD4+ in the cervical cancer groups was significantly higher than in the control group (p<0.01). The increased serum squamous cell carcinoma and carcinoembryonic antigen levels and CD4+CD25+/CD4+ ratio were risk factors for cervical cancer by logistic regression analysis (p<0.05).ConclusionsIn patients with cervical cancer, immune function was impaired compared with that in healthy women and patients with CIN, while squamous cell carcinoma and carcinoembryonic antigen levels were increased. Combined detection of the levels of peripheral blood immune cells and serum tumor markers may be helpful for early detection, diagnosis, and prognosis evaluation of patients with cervical cancer.

scholarly journals Recurrence of cancer cervix in patients treated by radical hysterectomy followed by adjuvant external beam radiotherapy

1970 ◽  
Vol 36 (2) ◽  
pp. 52-56 ◽  
Author(s):  
Fauzia Sobhan ◽  
Farzana Sobhan ◽  
Arif Sobhan
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Radical Hysterectomy ◽  
External Beam Radiotherapy ◽  
Late Recurrence ◽  
Distant Recurrence ◽  
External Beam ◽  
Distant Failure

One hundred and twenty patients with FIGO stage Ib-IIa cervical cancer who had radical hysterectomy prior to January 2003 in different hospitals of Bangladesh and thereafter received external beam pelvic radiotherapy (RT) at National Institute of Cancer Research and Hospital, Dhaka were studied. Until December 2007, 50 (42%) patients developed recurrence. Thirty-four (70%) patients experienced local recurrence, 13 (26%) distant recurrence and 2 (4%) both local and distant recurrence. Of 15 patients with distant metastasis, 6 (40%) experienced it in extra-pelvic lymph nodes. The median time to recurrence was 19 months (range 6-120 months) for local failure, 33 months (range 12-108 months) for distant failure and 25 months (range 13-36 months) for those with both local and distant failure. Eighty percent recurrences occurred within 36 months. There was significant correlation between lymph node metastasis and recurrence. All 5 (100%) patients with adenocarcinoma who had positive nodes experienced local recurrence compared with 18 of 49 (37%) squamous cell carcinoma patients with positive nodes. Recurrence more than 5 years after treatment developed in 5 (4%) patients. Mentionable, 4 (80%) out of 5 patients with late recurrence had squamous cell carcinoma with negative pelvic nodes. DOI: 10.3329/bmrcb.v36i2.6987Bangladesh Med Res Counc Bull 2010; 36: 52-56

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