ANALYSIS OF TREATMENT OUTCOMES IN LOCALLY ADVANCED CERVICAL CARCINOMA - AN INSTITUTIONAL STUDY

2021 ◽  
pp. 55-57
Author(s):  
S. Selvalakshmi
Keyword(s):  
Treatment Failure ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Treatment Modalities ◽  
Early Age ◽  
Carcinoma Cervix ◽  
Free Survival ◽  
Screening Programs ◽  
Advanced Cervical Carcinoma

Introduction:Carcinoma cervix is the second most common cancer among women in India. Carcinoma cervix is associated with many risk factors such as multi parity, early age at marriage, early age at coitus and the most important basic cause is poor socioeconomic status, illiteracy, lack of proper self-hygiene, lack of awareness of screening programs and treatment modalities. The main objective of this study is to analyze various outcomes following treatment of locally advanced carcinoma cervix and also to determine the causes of treatment failure so as to improve disease free survival, progression free survival and overall survival. Materials And Methods: A retrospective study was conducted among 191 locally advanced cervical carcinoma patients treated in the Department of Radiotherapy, Stanley Medical College and Hospital, Chennai during the period between 2015 and 2019. Various parameters of our study included age distribution, chief complaints at presentation, histopathological types and grades, staging, type of treatment, details of brachytherapy, response assessment and follow up. Results: Majority of them belong to stage II(50%) followed by stage III (41%). 14 patients belong to stage IV and only 4 patients belong to stage I. Among them 102 patients (53.4%) showed complete response and 34 patients (17.8%) showed partial response. Discussion: Most of the patients were in 4th and 5th decade which is very close to TNCRPregistry. Stage grouping of patients is considered most signicant in assessing the outcome of the treatment wherein it was found necessary to identify and present the symptoms at early stage to fasten the treatment and aim at complete cure. Conclusion: This study brings a clear picture of the possible reasons for treatment failure in locally advanced cervical carcinoma and highlights necessary steps to be implemented in improving infrastructure facilities in Government hospitals that would result in better treatment for poor patients with maximum benets.

scholarly journals The prognostic value of excission repair cross-complementation group one enzyme expression in locally advanced cervical carcinoma patients treated with cisplatin–based treatment: a meta–analysis

2019 ◽  
Vol 29 (1) ◽  
pp. 35-41
Author(s):  
Jiahao Zhu ◽  
Shengjun Ji ◽  
Qunchao Hu ◽  
Qingqing Chen ◽  
Zhengcao Liu ◽  
...  
Keyword(s):  
Cervical Carcinoma ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Complementation Group ◽  
Enzyme Expression ◽  
Free Survival ◽  
Advanced Cervical Carcinoma ◽  
Platinum Based Chemotherapy ◽  
Disease Free

BackgroundRecently, several studies observed that locally advanced cervical carcinoma with negative excision repair crross-complementation group one enzyme expression has better outcomes in cisplatin-based chemotherapy or chemoradiotherapy than carcinoma with positive excission repair cross-complementation group one enzyme expression. In this meta-analysis, we quantitatively evaluated the prognostic value of excission repair cross-complementation group one enzyme expression in locally advanced cervical carcinoma patients receiving platinum-based chemotherapy or chemoradiotherapy.MaterialsA systematic search for relevant studies was conducted in the PubMed, Cochrane Library, EMBASE and Medline databases. Fixed- or random-effects models were used for pooled analysis. The endpoints were overall survival and disease-free survival () reported as ORs and 95% CIs. The effects of excission repair cross-complementation group one enzyme expression on the clinicopathological parameters were measured by the pooled ORs and their 95% CIs.ResultsEight studies (612 patients in total) satisfied the inclusion criteria. Negative/low excission repair cross-complementation group one enzyme expression was significantly associated with better overall survival (OR, 1.92; 95% CI, 1.22 to 3.05; P = 0.005) and disease-free survival (OR, 5.77; 95% CI, 1.90 to 17.54; P = 0.002). Additionally, there were significant associations between excission repair cross-complementation group one enzyme expression and lymph node metastasis (OR, 2.57; 95% CI, 1.28 to 5.16; P = 0.008).ConclusionsThis meta-analysis suggested that pretreatment excission repair cross-complementation group one enzyme expression might be a useful biomarker to predict prognoses for locally advanced cervical carcinoma patients receiving platinum-based chemotherapy or chemoradiotherapy.

scholarly journals Evaluation of the response rate of chemo-radiation and brachytherapy in patients with locally advanced carcinoma cervix in a tertiary care center

2020 ◽  
Vol 8 (4) ◽  
pp. 1361
Author(s):  
Sukanya Semwal ◽  
Jaskaran S. Sethi ◽  
Munish Gairola ◽  
David K. Simson ◽  
Rajendra Kumar ◽  
...  
Keyword(s):  
Survival Rate ◽  
Local Recurrence ◽  
Tertiary Care ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Carcinoma Cervix ◽  
Free Survival ◽  
Advanced Carcinoma ◽  
Disease Free

Background: Incidence and mortality estimates are used to measure the burden of cancer in a population and survival estimates are ideal for evaluating the outcome of cancer control activities. Survival studies evaluate the quality and quantity of life of a group of patients after diagnosing the disease. The patient survival after the diagnosis of cervical cancer is indirectly influenced by socio-economic factors. The present study was carried out with an aim to evaluate the success rate of chemo-radiation followed by brachytherapy to the patients of locally advanced carcinoma (Ca.) cervix in a tertiary care center.Methods: All cases were staged according to the International Federation of Gynaecologists and Oncologists (FIGO) staging system. To illustrate the observed survival of cancer patients Kaplan-Meier curve was plotted. All the patients, except one, completed chemo-radiation and were retrospectively analyzed for the presence of local residual disease, local recurrence, distant metastases, radiation reactions, disease-free survival, and overall survival.Results: There were 22 patients of Carcinoma cervix reported in the radiation oncology department in the year 2018 and 2019. The overall treatment time ranged from 30 days to 178 days, with a median of 63 days. All the patients had a complete response after the treatment. The median follow-up time for all the patients was 15 months. Three patients had a metastatic recurrence and one patient developed distant metastases as well as local recurrence. Overall survival rate was 100% while the disease-free survival rate was 81.82%.Conclusions: The response to chemo-radiation in the treatment of locally advanced Carcinoma cervix is comparable to historic data and is well tolerated.

scholarly journals The Influence of Cisplatin Dose upon Survival in Concurrent Chemoradiotherapy of Locally Advanced Cervical Carcinoma with Weekly Cisplatin

2008 ◽  
Vol 51 (2) ◽  
pp. 95-99 ◽  
Author(s):  
Igor Sirák ◽  
Jiří Petera ◽  
Zdeněk Zoul
Keyword(s):  
Overall Survival ◽  
Cervical Carcinoma ◽  
Concurrent Chemoradiotherapy ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Hematological Toxicity ◽  
High Dose ◽  
Free Survival ◽  
Disease Free ◽  
Weekly Cisplatin

The objective of this study was to evaluate the influence of cisplatin dose upon 3-year overall and disease-free survival rate of patients with advanced cervical cancer treated with concurrent chemoradiotherapy with weekly cisplatin. Seventy-three patients with stage IIB – IVA cervical carcinoma were treated with pelvic (or pelvic + paraaortic) externalbeam radiotherapy, high-dose rate brachytherapy and concomitant chemotherapy with weekly cisplatin of 40 mg/m2 in the time period form January 2000 to December 2006 at our department. The 3-year overall survival and disease-free suvival rates were evaluated with regard to the number of cisplatin cycles applied during the external radiotherapy. Only twentyeight patients received the intended five doses of chemotherapy. The most frequent cause of chemotherapy delay was the acute hematological toxicity with leukopenia. The 3-year overall survival was 71 % and the 3-year disease-free survival was 61 %. Survival analyses didn’t prove a statistically significant influence of cisplatin dose upon 3-year survival in cervical carcinoma patients treated by exclusive chemoradiation with weekly cisplatin.

S177 – Treatment Efficacy of Locally Advanced Skin Cancers

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P135-P135
Author(s):  
Farhad Ardeshirpour ◽  
Smith J Apisarnthanarax ◽  
Richard Chan Woo Park ◽  
Hayes David ◽  
Julian Rosenman ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Head And Neck ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Treatment Modalities ◽  
Free Survival ◽  
Skin Cancers ◽  
Number Of Patients ◽  
Alive With Disease ◽  
Single Modality

Objectives To evaluate the treatment outcomes of our patients with locally advanced head and neck non-melatomatous skin cancers (HNNMSC). In this study we determined the 1-and 2-year disease-free survival and the 5-year overall survival of our patients treated with surgery, radiation, and chemotherapy, as a single modality or in combination. Methods Between 1994 and 2006, 197 patients with locally advanced HNNMSC were identified from our institution's Head and Neck Clinical Cancer Database. These patients had their medical records reviewed and of those, 66 met inclusion criteria. We included patients with pathological documentation of locally advanced HNNMSC. Results The majority of these patients were Caucasian and males with an average age of 69 years. 52 patients (79%) had squamous cell carcinoma and 14 (21%) had basal cell carcinoma. 23 patients (35%) received surgery alone, of which 20 (87%) showed no evidence of disease (NED). 5 patients (7%) received radiation alone, all of which showed NED except 1 who is alive with disease. 29 patients (44%) received surgery and radiation, of which 15 (51%) showed NED and the others recurred. 4 patients (6%) had chemotherapy plus radiation, of which 2 recurred. 5 patients (7%) had surgery plus chemotherapy and radiation, of which 2 showed NED, with the others recurred. Conclusions We cannot show statistical differences between different treatment modalities; however, there were more patients with NED in the surgery group compared to surgery and radiation. It is difficult to make conclusions about the chemoradiation because of the small number of patients.

scholarly journals Tumor Histology is an Independent Prognostic Factor in Locally Advanced Cervical Carcinoma. A Retrospective Study

2021 ◽  
Author(s):  
Lenny Gallardo-Alvarado ◽  
David Cantú-de León ◽  
Rebeca Ramirez-Morales ◽  
Gabriel Santiago-Concha ◽  
Salim Barquet-Muñoz ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Cervical Carcinoma ◽  
Cox Model ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Rank Test ◽  
Tumor Histology ◽  
Radiological Staging ◽  
Advanced Cervical Carcinoma ◽  
The Mean

Abstract Background: Even with different histologic origins, squamous cell carcinoma (SCC) and adenocarcinoma (AC) are considered a single entity, and the first-line treatment is the same. Locally advanced disease at the diagnosis of cervical cancer is the most important prognostic factor, the recurrence rate is high, making it necessary to evaluate prognostic factors other than clinical or radiological staging; histology could be one of them but continues to be controversial. The aim of this study was to evaluate tumor histology as a prognostic factor in terms of treatment outcomes, disease-free survival (DFS) and overall survival (OS) in a retrospective cohort of patients with Locally Advanced Cervical Carcinoma (LACC). Methods: The records of 1291patients with LACC were reviewed, all of them were treated with 45-50 Gy of external bean radiotherapy with concurrent chemotherapy and brachytherapy. A descriptive and comparative analysis was conducted. Treatment response was analyzed by the chi-square test; DFS and OS were calculated for each histology with the Kaplan-Meier method and compared with the log-rank test; and the Cox model was applied for the multivariate analysis. Results: We included 1291 patients with LACC treated from 2005 to 2014, of which 1154 (89·4%) had SCC and 137 (10·6%) had AC. Complete response to treatment was achieved in 933 (80·8%) patients with SCC and 113 (82·5%) patients with AC. Recurrence of the disease was reported in 29·9% of SCC patients and 31·9% of AC patients. Five-year DFS was 70% for SCC and 62·2% for AC. The five-year OS rates were 74·3% and 60% for SCC and AC, respectively. The mean DFS was 48·8 months for SCC vs 46·10 for AC (p=0·043), the mean OS was 50·8 for SCC and 47·0 for AC (p=0·002).Conclusion: Our findings support the hypothesis that SCC and AC are different clinical entities. Trial Registration: NCT04537273

scholarly journals Neoadjuvant Chemotherapy Followed by Surgery/Chemoradiotherapy Versus Radical Chemoradiotherapy in Stage IB2, IIA2, IIB Locally Advanced Cervical Carcinoma: A Retrospective Multicenter Study of 388 Patients

2021 ◽  
Author(s):  
Mingyuan He ◽  
Xing Su ◽  
Honglin Song ◽  
Ying Li ◽  
Fei Gu ◽  
...  
Keyword(s):  
Side Effects ◽  
Neoadjuvant Chemotherapy ◽  
Cervical Carcinoma ◽  
Radical Hysterectomy ◽  
Locally Advanced ◽  
Oncologic Outcomes ◽  
Standard Group ◽  
Free Survival ◽  
Advanced Cervical Carcinoma ◽  
Squamous Cancer

Abstract Purpose: The present study aimed to compare the oncologic outcomes and side effects between neoadjuvant chemotherapy followed by surgery/chemoradiotherapy and radical chemoradiotherapy for locally advanced cervical carcinoma (LACC).Methods: We conducted a retrospective review of patients with LACC (IB2, IIA2 and IIB stages) from six hospitals between June 2007 and January 2017. Results: A total of 388 patients were included, in which 278 patients received radical chemoradiotherapy (Standard group), and 110 patients received neoadjuvant chemotherapy. 65 patients of the 110 received radical hysterectomy (Surgery group), and 45 received chemoradiotherapy (Neo-Ra group). The 5-year overall survival (OS) in Surgery group (92.5%) was similar to that of the Standard group (84.9%), but both groups had higher OS rates than Neo-Ra group (75.6%). The 5-year disease-free survival (DFS) and progression-free survival (PFS) showed no differences among the three groups, respectively. There were no significant differences for grades 1-3 gastrointestinal and genitourinary toxicities among the three groups. No patient had grade 4 adverse effects. In multivariate analysis, tumor regression (CR vs. PR+SD+PD), pathological type (squamous cancer vs. non-squamous cancer) and lymph node metastasis (positive vs. negative) were considered as independent predictors of OS. Furthermore, besides above factors, the maximum diameter of tumors and adjuvant chemotherapy were also considered as significant prognostic factors for DFS and PFS.Conclusion: These findings showed that neoadjuvant chemotherapy followed by radical hysterectomy as a feasible and reliable therapy, resulting in encouraging oncologic outcomes and low side effects when compared to those obtained by standard chemoradiotherapy for IB2, IIA2, IIB stage cervical carcinoma patients.

Enhanced Radiosensitization with Interferon-α-2b and Cisplatin in the Treatment of Locally Advanced Cervical Carcinoma

1997 ◽  
Vol 67 (3) ◽  
pp. 309-315 ◽  
Author(s):  
Richard G. Stock ◽  
Peter Dottino ◽  
T.Scott Jennings ◽  
Mitchell Terk ◽  
J.Keith Dewyngaert ◽  
...  
Keyword(s):  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Interferon Α ◽  
Advanced Cervical Carcinoma

scholarly journals Endoscopic management versus radical nephroureterectomy for localized upper tract urothelial carcinoma in a high endemic region

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yung-Tai Chen ◽  
Chih-Chin Yu ◽  
Hsin-Chih Yeh ◽  
Hsiang-Ying Lee ◽  
Yuan-Hong Jiang ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Treatment Modalities ◽  
Endoscopic Management ◽  
Radical Nephroureterectomy ◽  
Endemic Region ◽  
Cancer Specific Survival ◽  
Curative Intent ◽  
Free Survival ◽  
Endoscopic Ablation ◽  
Endoscopic Group

AbstractOur aim was to analyze the clinical and survival differences among patients who underwent the two main treatment modalities, endoscopic ablation and radical nephroureterectomy. This study examined all patients who had undergone endoscopic management and RNU between Jul. 1988 and Mar. 2019 from the Taiwan UTUC registry. The inclusion criteria were low stage UTUC in RNU and all cases in endoscopic managed UTUC with a curative intent. The demographic and clinical characteristics were included for analysis. In total, 84 cases in the endoscopic group and 272 cases in the RNU group were enrolled for final analysis. The median follow-up period were 33.5 and 42.0 months in endoscopic and RNU group, respectively (p = 0.082). Comparison of Kaplan–Meier estimated survival curves between groups, the endoscopic group was associated with similar overall survival (OS), cancer specific survival (CSS), and intravesical recurrence free survival (IVRS) but demonstrated inferior disease free survival (DFS) (p = 0.188 for OS, p = 0.493 for CSS and p < 0.001 for DFS). Endoscopic management of UTUC was as safe as RNU in UTUC endemic region.

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