Efficacy and Toxicity of Neoadjuvant Chemotherapy Followed by Radiochemotherapy in Locally Advanced Cervical Cancer
|
|
- Reynard Shelton
- 6 years ago
- Views:
Transcription
1 original studies Efficacy and Toxicity of Neoadjuvant Chemotherapy Followed by Radiochemotherapy in Locally Advanced Cervical Cancer Nemes Adina 1, Nagy Viorica 1, 2, Todor Nicolae 1, Marita Andreea 1, Ordeanu Claudia 1, Rancea Alin 1, 2 1) Oncology Institute Prof.Dr.IonChiricuta Cluj-Napoca; 2) The IuliuHatieganu University of Medicine and Pharmacy Cluj-Napoca Background and aims: This study conducted in the Prof.Dr.IonChiricuta Oncology Institute, Cluj-Napoca (OICN) represents a nonrandomized, feasibility study in which the efficacy and toxicity of neoadjuvant chemotherapy (NACT) was analyzed before radiochemotherapy (RCT) in patients with locally advanced cervical cancer (LACC). Methods:In this study patients with histologically confirmed stage IIB-III cervical cancer treated in OICN between November 2010-September 2012 were included. Patients were administered two or three cycles of NACT two regimens Paclitaxel and Carboplatin (PC) or Topotecan and Cisplatin (TC),then they underwent concurrent RCT with Cisplatin or Carboplatin.External beam radiation therapy (EBRT) was administered at a total dose (TD) of 46Gy when patients were evaluated for surgery and those with favorable parametrial response were optionally operated.remaining patients underwent exclusive RCT up to a TD of 60Gy.Brachitherapy was associated to EBRT TD=10-20Gy. Local response was assessed at the end of NACT,at the end of RCT and for operated patients by the pathological outcome.results:in this study 112 patients with LACCwere included: stage IIB 31,stage IIIA 48 and stage IIIB 33 with a median age at diagnosis of 52 years.histology was mostly squamos cell carcinoma (86%).84 patients out of the 112 patients performed NACT with PC and 28 patients with TC.Tumor response evaluated at the end of NACT revealed a 53% objective response (OR= complete response(cr)+partial response(pr)): 81% OR for PC and 19% for TC (p=0.10). Complete response (CR) at the end of therapy was 29%:22% CR for the 65 patients that underwent exclusive RCT and 40% for the 47 patients that underwent surgery.the pathological CR (pcr) was obtained in 32 (68%) of the 47 patients that were operated. At a median follow-up of 17.4 months 98 patients (88%) presented CR,3 patients (3%) PR and 11 patients (10%) PD.Grade 1-2 hematological toxicity on all medullary lines were the most common hematological toxicity observed to NACT.Grade 3-4 anemia, leucopenia and neutropenia occurred in 6%, 8% and 27% of cases respectively. Conclusion: NACT administered before RCT brings a high response rate with manageable toxicity, but randomized, larger number and long term evaluation trials are necessary in order to confirm these data. Key words: advanced cervical cancer, neoadjuvant chemotherapy, local response Introduction Cevical cancer represents the second most common malignancy in women worldwide and it remains the second most common cause of cancer related death in women in Romania (1). Journal of Radiotheraphy & Medical Oncology September 2014 Vol. 20 No 1: 5-9 Address for correspondence: Adina Nemes Ion Chiricuta Oncology Institute Republicii Str Cluj-Napoca, Romania adina_mojo2003@yahoo.com Concurrent radiochemotherapy (RCT) represents the standard treatment for locally advanced cervical cancer (LACCC). With 5-year overall survival raging from 60% to 65% for stage IIB and from 25% to 50% for stage III, locally advanced cervical cancer is the most frequently diagnosed cervical cancer in Romania (2).Trying to improve the results of RCT as standard treatment in LACC, a potential benefit could be brought by neoadjuvant chemotherapy (NACT) before RCT. In literature there are several trials published regardingnact before surgery, but few trials about NACT before RCT. The advantages of NACT before RCT are tumor size reduction, increasedradiosensitivity, eradication of micrometastases and this represents an important
2 6 Nemes et al prognostic factor. In recent years NACT before RCT represented an important topic and it has been extensively studied, but as yet no consensus has been established. In this nonrandomized, feasibility study we analyzed the response and toxicity to NACT associated with RCT in patients with locally advanced cervical cancer treated in the Prof.Dr.IonChiricutaOncology Institute Cluj-Napoca (OICN). Material and methods Patients included in this study had histologically confirmed stage IIB-III cervical cancer (FIGO staging modified by MD Anderson Cancer Center) (3)treated in OICN between November 2010-September Before treatment all patients underwent several investigations as part of the initial workup: hematology and biochemistry profile, chest X-ray, abdominal and pelvic computed tomography (CT). All patients included in this study received NACT two or three cycles, two regimens Paclitaxel 175mg/m 2 and Carboplatin AUC5 (PC) or Topotecan 0.75mg/m 2 and Cisplatin 50mg/m 2 (TC) administered every three weeks. Three weeks after the completion of the last NACT cycle, patients started RCT. The radiosensitizer chemotherapeutic agents administered concurrently with external beam radiation therapy (EBRT) were Cisplatin two regimens (20mg/m 2 5 days every three weeks or 40mg/m 2 weekly) or Carboplatin AUC2. All patients underwent EBRT to a total dose (TD) of 46Gy; at 46Gy patients were evaluated for surgery and those with favorable parametrial response were optionally operated and underwent radical hysterectomy and pelvic lymph node dissection. Patients who did not undergo surgery continued with EBRT up to a TD of 60 Gy. EBRT was associated with brachytherapy TD 10 Gy/2fractions for patients who underwent surgery or 20 Gy/4 fractions for patients who underwent exclusive RCT. Tumor response was evaluated according to the WHO criteria (4) defined as complete response-cr, partial response-pr, stable disease-sd and progressive disease-pd by pelvic examination three weeks after the administration of the last NACT cycle, before RCT and at the end of RCT. For the operated patients the tumor response was confirmed by the pathological outcome. Pathological CR was defined as the absence of tumor cells in the cervix, parametrium, vaginal cuff and pelvic lymph nodes. National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.0 were used for the classification of recorded NACT related toxicities. Results 12 patients with locally advanced cervical cancer were included in this study: stage IIB 31 patients (28%), stage IIIA 48 patients (42%) and stage IIIB 33 patients (30%). Median age at diagnosis was 52 years (22-72 years old); the median tumor size was 4 cm (1-7 cm) and regarding the histology, 86% of tumors were squamos cell carcinomas, 8% adenocarcinomas and 6% were other histologies (adenosquamos carcinoma, clear cell carcinoma,small cell carcinoma) (Table I). Table I. Patients characteristics November 2010-september patients Age (years) min 22 max 72 median 52 FIGO stage IIB 31 (28%) IIIA 48 (42%) IIIB 33 (30%) Tumor size (baseline) min 1 max 7 median 4 Histological type squamos cell 86% carcinomas adenocarcinomas 8% other histologies 6% Follow-up min 3.8months max 32months median 17,4months 75% (84 patients ) out of the 112 patients performed NACT with PC and 25% ( 28 patients) performed NACT with TC. 59 patients (53%) achieved an objective response (OR= CR+PR) after the administration of NACT. Regarding the NACT regimen administered we observed a 81% OR for PC versus 19% for TC, without statistical significance (p=0.10) (Table II). When evaluating the response to NACT in comparison with the number of NACT cycles administered the OR was 56% with the administration of two cycles and 70% with the administration of three cycles of PC. For the TC regimen the OR after the administration of two cycles was 33% versus 40% after the administration of three cycles (Table III). Table II.Response to neoadjuvant chemotherapy (regimen) Therapeutical response at the end of neoadjuvant chemotherapy OR SD Total (CR+PR) Neoadjuvant chemotherapy regimen Paclitaxel + Carboplatin 48 (81%) 36 (68%) 84 Topotecan + Cisplatin 11 (19%) 17 (32%) Total p=0.10 (NS) 28
3 Efficacy and toxicity of neoadjuvant chemotherapy followed by radiochemotherapy in locally advanced cervical cancer 7 Table III. Response to neoadjuvant chemotherapy (regimen and number of cycles administered) Therapeutical response at the end of neoadjuvant chemotherapy OR (CR+PR) SD Total Neoadjuvant Paclitaxel + Carboplatin 1 cycle 6 (100%) 6 chemotherapy regimen 2 cycles 25 (56%) 20 (44%) 45 3 cycles 23 (70%) 10 (30%) 33 Topotecan + Cisplatin 1cycle 1 (100%) 1 2 cycles 4 (33%) 8 (67%) 12 3 cycles 6 (40%) 9 (60%) 15 Total 59 (53%) 53 (47%) 112 From the 112 patients 65 performed exclusive RCT with a CR in 14 patients (22%) and 47 patients underwent surgery with a CR in 19 patients (40%), with a CR at the end of treatment of 29% (Table IV). Regarding the concurrent chemotherapy regimen administered, 90% of patients received Cisplatin 20mg/m 2 5 days every three weeks, 8% of patients received Cisplatin 40mg/m 2 weekly and 3% of patients received Carboplatin AUC2. Out of the 101 patients receiving Cisplatin 20mg/m 2 5 days every three weeks, 25 patients received 1 cycle, 69 patients received 2 cycles and 7 patients received 3 cycles. Table IV. Response to concurrent radio-chemotherapy Clinical response at the end of RCT CR non CR Total Surgery- 14 (22%) 51 (78%) 65 Surgery+ 19 (40%) 28 (60%) 47 Total 33 (29%) 79 (71%) 112 For the 47 patients that underwent surgery there was a 68% (32 patients) pcr observed. The pcr observed with the administration of 3 cycles of NACT for the operated patients was of 79% CR for the PC regimen and 56% CR for the TC regimen (Table V).When correlating the clinical and pathological CR for the operated patients an accuracy of 68% was obtained: clinically a 40% CR was observed (at the end of RCT) and histopathologically a 68% CR was observed (surgery was performed four to six weeks after the end of RCT). Table V. Correlation between pcr and NACT Histopathology Total pcr non pcr Paclitaxel cycles 11 (69%) 5 (31%) 16 Carboplatin 3 cycles 15(79%) 4 (21%) 19 Topotecan cycles 1 (33%) 2 (67%) 3 Cisplatin 3 cycles 5(56%) 4(44%) 9 Total 32 (68%) 15 (32%) 47 At a median follow-up of 17.4 months 98 patients (88%) presented CR, 3 patients (3%) PR and 11 patients (10%) PD. A strong correlation with the stage of the disease (stage IIB, IIIA and IIIB) was observed regarding the response to treatment 97% vs. 85% vs. 82% CR and 3% vs. 8% vs. 18% PD, respectively. Hematological toxicity to NACT was mild or moderate, most common toxicities were grade 1-2 on all medullary lines. Grade 3-4 anemia, leucopenia and neutropenia was observed in 6%, 8% and 27% of cases respectively, with a more severe toxicity as the administration of multiple cycles of NACT. There was 2% grade 3-4 anemia after the administration of one cycle of NACT and 4% after the administration of three cycles.grade 3-4 leucopenia was observed in 2% of cases after the administration of two cycles of NACT and in 6% of cases after the administration of three cycles of NACT. The most common grade 3-4 hematologic toxicity to NACT observed was neutropenia; it was observed in 4% of cases after the administration of one cycle of NACT, 8% of cases after the administration of two cycles of NACT and 15% of cases after the administration of three cyclesof NACT. When evaluating the influence of NACT on the possibility of administrating all required cycles of concomitant chemotherapy (CCT), we observed that 25 patients received only one cycle of concurrent Cisplatin. 10 patients out of the 25 patients presented grade 3-4 hematologic toxicity to NACT and 10 patients presented grade 3-4 hematologic toxicity to CCT. Only 3 patients out of the 25 patients presented grade 3-4 hematologic toxicity both to NACT and CCT.Regarding grade 3-4 hematologic toxicity to CCT in these patients, the most common toxicities recorded were leucopenia and neutropenia (Table VI). Discussion In recent years NACT before RCT represented an important topic as it may facilitate local therapy by tumor size reduction, increaseradiosensitivity and reduce the risk of relapse by the eradication of micrometastases. Eventhough there are many published trials with NACT before surgery,
4 8 Nemes et al Table VI. Hematological toxicity associated with NACT Hb Pl WBC N grade 1-2 grade 3-4 grade 1-2 grade 3-4 grade 1-2 grade 3-4 grade1-2 grade 3-4 after C1 25% 2% 9% - 7% - 14% 4% after C2 40% - 10% - 13% 2% 22% 8% after C3 44% 4% 17% - 27% 6% 25% 15% and recently data from several trials of NACT before RCT became available, no NACT regimen emerged. All NACT regimes are platinum based. The administration of triple regimes such as cisplatin, vincristine and bleomycin (VBP) or paclitaxel, cisplatin and ifosfamide (TIP) determined an OR raging from 84% up to 87.7% (5,6,7,8). Other regimens using irinotecan, mitomycin-c, etoposid or gemcitabine determined an 69.7%-95% OR (9,10,11). OR rates of up to 95% were obtained with the administration of paclitaxel combined with either cisplatin or carboplatin (12,13,14). Park et al reported a 39.5% CR, with a 11.6% pcr and 51.2% PR after the administration of three courses of paclitaxel and cisplatin in patients with stage IB2-IIB cervical cancer (13). In a phase II prospective study of topotecan and cisplatin as NACT in locally advanced cervical cancer (stage IB2-IIIB) Manci et al showed a 15.8% pcr and 73.7% ppr after the administration of three consecutive cycles of NACT (15). Recently published studies of NACT in LACC using dosedense paclitaxel and carboplatin administered weekly for six cycles reported an OR between 67.8%-70% (16,17). In our study we obtained a 53% OR to NACT: 81% OR for the PC regimen and 19% OR for the TC regimen. PC was found to be superior to TC in terms of OR with a 62% difference, but without statistical significance(p=0.10). The pcr observed in the 47 patients that underwent surgery was 68%. The superiority of the PC regimen was also revealed by the correlation between pcr and the administration of 3 cycles of NACT and the same RCT schedule: 79% pcr after the administration of three cycles of PC and a 56% pcr after the administration of three TC cycles, but without statistical significance (p=0.41). The number of NACT cycles administered proved to be important for the response to NACT. For the PC regimen the administration of three cycles proved to bring an improvement in terms of OR (56% after two cycles vs. 70% after three cycles ).For the TC regimen the OR was higher with the administration of three cycles than two cycles (40% vs. 33%). The CR to RCT in our study was obtained in 29% of the 65 patients that underwent RCT. ThepCR observed in the 47 patients that underwent surgery was 68% (32 patients). In a pilot study of NACT with weekly paclitaxel and carboplatin followed by chemoradiation in LACC, Singh et al reported a CR in 23 out of the 24 patients that underwent RCT, but this was a small study performed on only 28 patients (14). In a larger study performed on 46 patients McCormack et al showed a 85% OR to RCT in patients with LACC that received dose-dense NACT with PC (15). Hematologic toxicity during NACT and CCT represents an important issue, as it can influence the ability of delivering the standard treatment to patients with LACC. 11% of patients were reported to have developed grade 3-4 hematologic toxicity during NACT and 41% of patients were reported to have developed grade 3-4 hematologic toxicity during RCT in McCormack s study (17). The most common hematologic toxicity both to NACT and CCT reported is neutropenia. Sight et al reported a grade 3-4 neutropenia in 28.5% of patients during NACT and in 29% of patients during RCT (16). In our study grade 3-4 hematologic toxicity to NACT was recorded in 6% of cases anemia, 8% of cases leucopenia and 27% of cases neutropenia. The most common hematologic toxicity recorded was neutropenia, being recorded even after the administration of one cycle of NACT. NACT did not seem to influence the administration of the required number of CCT cycles as only 3 patients out of the 25 patients that received only one cycle of concurrent Cisplatin presented grade 3-4 hematologic toxicity both to NACT and CCT. Conclusions High response rates can be achieved with NACT in locally advanced cervical cancer with manageable toxicity. In our study the paclitaxel and carboplatin regimen proved to be superior to topotecan and cisplatin in terms of overall response rates. The administration of three cycles of paclitaxel and carboplatin seemed to bring a benefit in comparison with two cycles regarding tumor response. Given the various NACT regimens administered in several studies, heterogeneity of stages in these studies and the small number of patients included, randomized, larger number and long term evaluation trials are necessary in order to confirm these data. References 1. World Health Organization Report: Comprehensive Cervical Cancer Control: a Guide to Essential Practice. World Health Organization Web site Available at health/ publications/cervical_cancer_gep/index.htm 2. Quinn MA, Benedet JL, Odicino F, et al. Carcinoma of the cervix uteri. FIGO 6th Annual Report on the Results of Treatment
5 Efficacy and toxicity of neoadjuvant chemotherapy followed by radiochemotherapy in locally advanced cervical cancer 9 in Gynecological Cancer. Int J GynecolObstet 2006;95(Suppl 1):S43-S Eifel PJ. Problems with the clinical staging of carcinoma of the cervix. Semin Oncol 2004; 4(1):1 4. WHO Handbook for reporting results of cancer treatment. World Health Organization Offset Publication no.48, Geneva, Chang TC, Lai CH, Hong JH, et al. Randomized trial of neoadjuvantcisplatin, vincristine, bleomycin, and radical hysterectomy versus radiation therapy for bulky stage IB and IIAcervical cancer. J Clin Oncol 2000;18: Chang HC, Lai CH, Chou PC, et al. Neoadjuvant chemotherapy with cisplatin, vincristine, and bleomycin and radical surgery in early-stage bulky cervical carcinoma. Cancer Chemother Pharmacol 1992;30: Buda A, Fossati R, Colombo N, et al. Randomized trial of neoadjuvant chemotherapy comparing paclitaxel, ifosfamide, and cisplatin with ifosfamide and cisplatin followed by radical surgery in patients with locally advanced squamous cell cervical carcinoma: the SNAP01 (Studio Neo-AdjuvantePortio) Italian Collaborative Study. J Clin Oncol 2005;23: Zanetta G, Lissoni A, Pellegrino A, et al. Neoadjuvant chemotherapy with cisplatin,ifosfamide and paclitaxel for locally advancedsquamous cell-cervicalcancer. Ann Oncol 1998;9: Kokawa K, Nishimura R, Fujii T, Umesaki N. Neoadjuvant chemotherapy with irinotecan and mitomycin-c for locally advanced squamous cell carcinoma of the uterine cervix. Anticancer Res 2007;27: Bae JH, Lee SJ, Lee A, et al. Neoadjuvantcisplatin and etoposide followed by radical hysterectomy for stage IB-2B cervical cancer. GynecolOncol 2008;111: Duenas-Gonzalez A, Lopez-Graniel C, Gonzalez-Enciso A, et al.concomitantchemoradiation versus neoadjuvant chemotherapy in locally advanced cervical carcinoma: results from two consecutive phase II studies. Ann Oncol 2002;13: Duenas-Gonzalez A, Lopez-Graniel C, Gonzalez-Enciso A, et al. A Phase II study of multimodality treatment for locally advanced cervical cancer: neodjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatinchemoradiation. Ann Oncol 2003;14: Park DC, Kim JH, Lew YO, et al. Phase II trial of neoadjuvant paclitaxel and cisplatin in uterine cervical cancer. GynecolOncol 2004;92: Cho YH, Kim DY, Kim JH, el al. Comparative study of neoadjuvant chemotherapy before radical hysterectomy and radical surgery alone in stage IB2-IIA bulky cervical cancer. J Gynecol Oncol 2009;20: Manci N, Marchetti C, Di Tucci C, et al. A prospective phase II study of topotecan (Hycamtin R) and cisplatin as neoadjuvant chemotherapy in locally advanced cervical cancer. Gynecol Oncol 2011;122: Singh RB, Chander S, Mohanti BK, et al. Neoadjuvant chemotherapy with weekly paclitaxel and carboplatin followed by chemoradiation in locally advanced cervical carcinoma: a pilot study. Gynecol Oncol 2013;129: McCormack M, Kadalayil L, Hackshaw A, et al. A phase II study of weekly neoadjuvant chemotherapy followed by radical chemoradiation for locally advanced cervical cancer. Br J Cancer 2013;108:
ONCOLOGY LETTERS 3: , 2012
ONCOLOGY LETTERS 3: 641-645, 2012 Treatment of early bulky cervical cancer with neoadjuvant paclitaxel, carboplatin and cisplatin prior to laparoscopical radical hysterectomy and pelvic lymphadenectomy
More informationUpdate on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer
Update on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer Nicoletta Colombo, MD University of Milan-Bicocca European Institute of Oncology Milan, Italy NACT in Cervical Cancer NACT Stage -IB2 -IIA>4cm
More informationThe Efficacy and Safety of Neoadjuvant Chemotherapy in Treatment of Locally Advanced Carcinoma Cervix
The Journal of Obstetrics and Gynecology of India (July August 2013) 63(4):273 278 DOI 10.1007/s13224-012-0342-6 ORIGINAL ARTICLE The Efficacy and Safety of Neoadjuvant Chemotherapy in Treatment of Locally
More informationChemotherapy for Cervical Cancer. Matsue City Hospital Junzo Kigawa
Chemotherapy for Cervical Cancer Matsue City Hospital Junzo Kigawa Introduction Worldwide, cervical cancer is the second most common cancer in women and affects 530,000 new patients and 275,000 deaths.
More informationA phase II study of weekly paclitaxel and cisplatin followed by radical hysterectomy in stages IB2 and IIA2 cervical cancer AGOG14-001/TGOG1008
A phase II study of weekly paclitaxel and cisplatin followed by radical hysterectomy in stages IB2 and IIA2 cervical cancer AGOG14-001/TGOG1008 NCT02432365 Chyong-Huey Lai, MD On behalf of Principal investigator
More informationChapter 5 Stage III and IVa disease
Page 55 Chapter 5 Stage III and IVa disease Overview Concurrent chemoradiotherapy (CCRT) is recommended for stage III and IVa disease. Recommended regimen for the chemotherapy portion generally include
More informationGynecologic Cancer InterGroup Cervix Cancer Research Network. Management of Cervical Cancer in Resource Limited Settings.
Management of Cervical Cancer in Resource Limited Settings Linus Chuang MD Conflict of Interests None Cervical cancer is the fourth most common malignancy in women worldwide 530,000 new cases per year
More informationThree-Dimensional Conformal Radiotherapy for Stage IIB- IIIB Cervical Cancer: Experience of the Oncology Institute Prof.Dr. Ion Chiricuta Cluj-Napoca
original studies Three-Dimensional Conformal Radiotherapy for Stage IIB- IIIB Cervical Cancer: Experience of the Oncology Institute Prof.Dr. Ion Chiricuta Cluj-Napoca Anamaria Sipos 1, Noemi Besenyodi
More informationProspective comparative study of dose dense neo-adjuvant chemotherapy followed by chemo-radiation and definitive chemoradiation
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Karpurmath SV et al. Int J Reprod Contracept Obstet Gynecol. 2016 Sept;5(9):2909-2914 www.ijrcog.org pissn 2320-1770 eissn
More informationNon commercial use only. The role of neoadjuvant chemotherapy in the management of locally advanced cervix cancer: a systematic review
Oncology Reviews 2014; volume 8:250 The role of neoadjuvant chemotherapy in the management of locally advanced cervix cancer: a systematic review Mohammed Osman Oncology Consultant, General Organization
More informationUPDATE IN THE MANAGEMENT OF INVASIVE CERVICAL CANCER
UPDATE IN THE MANAGEMENT OF INVASIVE CERVICAL CANCER Susan Davidson, MD Professor Department of Obstetrics and Gynecology Division of Gynecologic Oncology University of Colorado- Denver Anatomy Review
More informationLocally advanced disease & challenges in management
Gynecologic Cancer InterGroup Cervix Cancer Research Network Cervix Cancer Education Symposium, February 2018 Locally advanced disease & challenges in management Carien Creutzberg Radiation Oncology, Leiden
More informationComparative Efficacy of Cisplatin vs. Gemcitabine as Concurrent Chemotherapy for Untreated Locally Advanced Cervical Cancer: A Randomized Trail
Comparative Efficacy of Cisplatin vs. Gemcitabine as Concurrent Chemotherapy for Untreated Locally Advanced Cervical Cancer: A Randomized Trail Dr. Nishee Srivastava MD, Dr. Kamal Sahani MD, Dr. Manoj
More informationChapter 8 Adenocarcinoma
Page 80 Chapter 8 Adenocarcinoma Overview In Japan, the proportion of squamous cell carcinoma among all cervical cancers has been declining every year. In a recent survey, non-squamous cell carcinoma accounted
More informationManagement of Cervical Cancer in Resource Limited Settings
Management of Cervical Cancer in Resource Limited Settings Linus Chuang MD MPH MS Professor, Gynecologic Oncology Icahn School of Medicine at Mount Sinai New York NY 84% of incidence and death occur in
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Carcinoma of the Uterine Cervix
THIS DOCUMENT North of Scotland Cancer Network Carcinoma of the Uterine Cervix UNCONTROLLED WHEN PRINTED DOCUMENT CONTROL Prepared by A Kennedy/AG Macdonald/Others Approved by NOT APPROVED Issue date April
More informationRESEARCH ARTICLE. Kuanoon Boupaijit, Prapaporn Suprasert* Abstract. Introduction. Materials and Methods
RESEARCH ARTICLE Survival Outcomes of Advanced and Recurrent Cervical Cancer Patients Treated with Chemotherapy: Experience of Northern Tertiary Care Hospital in Thailand Kuanoon Boupaijit, Prapaporn Suprasert*
More informationYukiharu Todo 1, Hidemichi Watari 2. Abstract
Review Article on Cervical Cancer Concurrent chemoradiotherapy for cervical cancer: background including evidence-based data, pitfalls of the data, limitation of treatment in certain groups Yukiharu Todo
More informationARROCase: Locally Advanced Endometrial Cancer
ARROCase: Locally Advanced Endometrial Cancer Charles Vu, MD (PGY-3) Faculty Advisor: Peter Y. Chen, MD, FACR Beaumont Health (Royal Oak, MI) November 2016 Case 62yo female with a 3yr history of vaginal
More informationGCIG Rare Tumour Brainstorming Day
GCIG Rare Tumour Brainstorming Day Relatively (Not So) Rare Tumours Adenocarcinoma of Cervix Keiichi Fujiwara, Ros Glasspool Benedicte Votan, Jim Paul Aim of the Day To develop at least one clinical trial
More informationQuimio Radioterapia en Cancer de Cervix
Quimio Radioterapia en Cancer de Cervix HIGINIA R. CÁRDENES PROFESSOR RADIATION ONCOLOGY CLINICAL DIRECTOR SCHNECK CANCER CENTER Worldwide incidence of cervical cancer 2014, 12.360 cases Global incidence
More informationWeekly Versus Triweekly Cisplatin-Based Chemotherapy Concurrent With Radiotherapy in the Treatment of Cervical Cancer
REVIEW ARTICLE Weekly Versus Triweekly Cisplatin-Based Chemotherapy Concurrent With Radiotherapy in the Treatment of Cervical Cancer A Meta-Analysis Xingxing Chen, MD,* Haizhou Zou, MD,Þ Huifang Li, MD,*
More informationLung Cancer Epidemiology. AJCC Staging 6 th edition
Surgery for stage IIIA NSCLC? Sometimes! Anne S. Tsao, M.D. Associate Professor Director, Mesothelioma Program Director, Thoracic Chemo-Radiation Program May 7, 2011 The University of Texas MD ANDERSON
More informationAdjuvant Therapies in Endometrial Cancer. Emma Hudson
Adjuvant Therapies in Endometrial Cancer Emma Hudson Endometrial Cancer Most common gynaecological cancer Incidence increasing in Western world 1-2% cancer deaths 75% patients postmenopausal 97% epithelial
More informationAlgorithms for management of Cervical cancer
Algithms f management of Cervical cancer Algithms f management of cervical cancer are based on existing protocols and guidelines within the ESGO comunity and prepared by ESGO Educational Committe as a
More informationFoROMe Lausanne 6 février Anita Wolfer MD-PhD Cheffe de clinique Département d Oncologie, CHUV
FoROMe Lausanne 6 février 2014 Anita Wolfer MD-PhD Cheffe de clinique Département d Oncologie, CHUV Epithelial Ovarian Cancer (EOC) Epidemiology Fifth most common cancer in women and forth most common
More informationCOX-2 inhibitor and irradiation. Saitama Cancer Center Kunihiko Kobayashi MD, PhD
COX-2 inhibitor and irradiation Saitama Cancer Center Kunihiko Kobayashi MD, PhD Synthesis of prostaglandins from arachidonic acid by cyclooxygenase (COX) enzymes JNCI 95:1440, 2003 Difference between
More information17 th ESO-ESMO Masterclass in clinical Oncology
17 th ESO-ESMO Masterclass in clinical Oncology Cervical and endometrial Cancer Cristiana Sessa IOSI Bellinzona, Switzerland Berlin, March 28 th, 2018 Presenter Disclosures None Cervical Cancer Estimated
More informationAn Unusual Case of Cervical Cancer with Inguinal Lymph Node Metastasis: A Case Report and Review of the Literature
Archives of Clinical and Medical Case Reports doi: 10.26502/acmcr.9655003 Volume 1, Issue 1 Case Report An Unusual Case of Cervical Cancer with Inguinal Lymph Node Metastasis: A Case Report and Review
More informationreceive adjuvant chemotherapy
Women with high h risk early stage endometrial cancer should receive adjuvant chemotherapy Michael Friedlander The Prince of Wales Cancer Centre and Royal Hospital for Women The Prince of Wales Cancer
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer
THIS DOCUMENT North of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer Based on WOSCAN CMG with further extensive consultation within NOSCAN UNCONTROLLED WHEN PRINTED DOCUMENT
More informationInvasive Cervical Cancer: Squamous Cell, Adenocarcinoma, Adenosquamous
Note: If available, clinical trials should be considered as preferred treatment options for eligible patients (www.mdanderson.org/gynonctrials). Other co-morbidities are taken into consideration prior
More informationtrial update clinical
trial update clinical by John W. Mucenski, BS, PharmD, Director of Pharmacy Operations, UPMC Cancer Centers The treatment outcome for patients with relapsed or refractory cervical carcinoma remains dismal.
More informationOutcomes and prognostic factors of cervical cancer after concurrent chemoradiationjog_
bs_bs_banner doi:10.1111/j.1447-0756.2012.01871.x J. Obstet. Gynaecol. Res. Vol. 38, No. 11: 1315 1320, November 2012 Outcomes and prognostic factors of cervical cancer after concurrent chemoradiationjog_1871
More informationTratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón
Tratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón Santiago Ponce Aix Servicio Oncología Médica Hospital Universitario 12 de Octubre Madrid Stage III: heterogenous disease
More informationConcurrent chemoradiotherapy with low-dose daily cisplatin for high risk uterine cervical cancer: a long-term follow-up study
Original Article J Gynecol Oncol Vol. 24, No. 2:108-113 http://dx.doi.org/10.3802/jgo.2013.24.2.108 pissn 2005-0380 eissn 2005-0399 Concurrent chemoradiotherapy with low-dose daily cisplatin for high risk
More informationNeoadjuvant and postoperative chemotherapy with paclitaxel plus cisplatin for the treatment of FIGO stage IB cervical cancer in pregnancy
Case Report Obstet Gynecol Sci 2014;57(6):539-543 http://dx.doi.org/10.5468/ogs.2014.57.6.539 pissn 2287-8572 eissn 2287-8580 Neoadjuvant and postoperative chemotherapy with paclitaxel plus cisplatin for
More informationINTRODUCTION. J. Radiat. Res., 53, (2012)
J. Radiat. Res., 53, 281 287 (2012) The Effects of Two HDR Brachytherapy Schedules in Locally Advanced Cervical Cancer Treated with Concurrent Chemoradiation: A Study from Chiang Mai, Thailand Ekkasit
More informationRadiotherapy & Cervical Cancer Dr Mary McCormack Consultant Clinical Oncologist University College Hospital, London,UK
Lead Group Log Radiotherapy & Cervical Cancer Dr Mary McCormack Consultant Clinical Oncologist University College Hospital, London,UK Cervical Cancer treatment Treatment planning should be made on a multidisciplinary
More informationCervical Cancer Guidelines L and SC Network July Introduction:
Cervical Cancer Guidelines L and SC Network July 2018 Introduction: There was a total number of 442 cases of cervix cancer diagnosed in Lancashire and South Cumbria Cancer Network in the period 2005 2009
More informationOvarian Cancer Survival. Ovarian Cancer Follow-up. Ovarian Cancer Treatment. Management of Recurrent Ovarian Carcinoma. 15,520 cancer deaths
Management of Recurrent Ovarian Carcinoma Lee-may Chen, M.D. Department of Obstetrics, Gynecology, & Reproductive Sciences UCSF Comprehensive Cancer Center Ovarian Cancer Survival United States, 28: 1
More informationConcurrent chemoradiation in treatment of carcinoma cervix
N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 4-8 May -June 2007 REVIEW Concurrent chemoradiation in treatment of carcinoma cervix Meeta Singh, Rajshree Jha, Josie Baral, Suniti Rawal Dept of Obs/Gyn, TU Teaching
More informationExtrafascial hysterectomy after concurrent chemoradiotherapy in locally advanced cervical adenocarcinoma
J Gynecol Oncol. 2016 Jul;27(4):e40 pissn 2005-0380 eissn 2005-0399 Original Article Extrafascial hysterectomy after concurrent chemoradiotherapy in locally advanced cervical adenocarcinoma Jie Yang, Keng
More informationBiomedical Research 2018; 29 (10):
Biomedical Research 2018; 29 (10): 2116-2121 ISSN 0970-938X www.biomedres.info Concurrent chemoradiotherapy with paclitaxel and cisplatin for patients of locally advanced cervical squamous cell carcinoma:
More informationCervical Cancer 3/25/2019. Abnormal vaginal bleeding
Cervical Cancer Abnormal vaginal bleeding Postcoital, intermenstrual or postmenopausal Vaginal discharge Pelvic pain or pressure Asymptomatic In most patients who are not sexually active due to symptoms
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX Site Group: Gynecology Cervix Author: Dr. Stephane Laframboise 1. INTRODUCTION 3 2. PREVENTION 3 3. SCREENING AND
More informationChemotherapy or Observation in Stage I-II Intermediate or High Risk Endometrial Cancer
Find Studies About Studies Submit Studies Resources About Site Chemotherapy or Observation in Stage I-II Intermediate or High Risk Endometrial Cancer The safety and scientific validity of this study is
More informationHigh-Dose-Rate Orthogonal Intracavitary Brachytherapy with 9 Gy/Fraction in Locally Advanced Cervical Cancer: Is it Feasible??
DOI 10.1007/s13224-015-0812-8 ORIGINAL ARTICLE High-Dose-Rate Orthogonal Intracavitary Brachytherapy with 9 Gy/Fraction in Locally Advanced Cervical Cancer: Is it Feasible?? Saptarshi Ghosh 1 Pamidimukalabramhananda
More informationChun-Chieh Wang, MD and Feng-Yuan Liu, MD/ Prof. Chyong-Huey Lai, MD
Concept/trial design presentation A Phase 2 Trial of Pembrolizumab Combined with Chemoradiation for Patients with [ 18 F]-FDG PET/CT-defined Poor-prognostic Cervical Cancer Chun-Chieh Wang, MD and Feng-Yuan
More informationCountry Presentations of FNCA FY2007 Workshop on Radiation Oncology
Country Presentations of FNCA FY2007 Workshop on Radiation Oncology Annex 3 Country presentations on CERVIX-III -China: Total Patients: 18, 8 alive: 1 with metastasis lung, another one metastasis to liver;
More informationClinical Management Guideline for Small Cell Lung Cancer
Diagnosis and Staging: Key Points 1. Ensure a CT scan that is
More informationECC or Margins Positive?
CLINICAL PRESENTATION This practice algorithm has been specifically developed for M. D. Anderson using a multidisciplinary approach and taking into consideration circumstances particular to M. D. Anderson,
More informationThe clinicopathological features and treatment modalities associated with survival of neuroendocrine cervical carcinoma in a Chinese population
Zhang et al. BMC Cancer (2019) 19:22 https://doi.org/10.1186/s12885-018-5147-2 RESEARCH ARTICLE Open Access The clinicopathological features and treatment modalities associated with survival of neuroendocrine
More informationHypofractionated RT in Cervix Cancer. Anuja Jhingran, MD
Hypofractionated RT in Cervix Cancer Anuja Jhingran, MD Hypofractionated RT in Cervix Cancer: Clinicaltrials.gov 919 cervix trials 134 hypofractionated RT trials Prostate, breast, NSCLC, GBM 0 cervix trials
More informationEui-Sok Sol 1, Tae Sung Lee 1, Suk Bong Koh 1, Hun Kyu Oh 2, Gi Won Ye 3, Youn Seok Choi 1 INTRODUCTION
J Gynecol Oncol Vol. 20, No. 1:28-34, March 2009 DOI:10.3802/jgo.2009.20.1.28 Original Article Comparison of concurrent chemoradiotherapy with cisplatin plus 5-fluorouracil versus cisplatin plus paclitaxel
More informationORIGINAL ARTICLE. Summary. Introduction
Journal of BUON 17: 740-745, 2012 2012 Zerbinis Medical Publications. Printed in Greece ORIGINAL ARTICLE Cisplatin monotherapy with concurrent radiotherapy versus combination of cisplatin and 5-fluorouracil
More informationManagement of high risk early cervical cancer - a view of surgeon Dan DY Kim, M.D., Ph.D.
Management of high risk early cervical cancer - a view of surgeon Dan DY Kim, M.D., Ph.D. Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
More informationEvolving Treatment Strategies for Cervical Cancer
Evolving Treatment Strategies for Cervical Cancer Nadeem Abu-Rustum, MD Memorial Sloan Kettering Cancer Center Evolving Treatment Strategies 1. Surgery 2. Radiation 3. Chemotherapy Incidence of cervix
More informationSurvival Benefits of Neoadjuvant Chemotherapy Followed by Radical Surgery versus Radiotherapy in Locally Advanced Chemoresistant Cervical Cancer
J Korean Med Sci 2006; 21: 683-9 ISSN 1011-8934 Copyright The Korean Academy of Medical Sciences Survival Benefits of Neoadjuvant Chemotherapy Followed by Radical Surgery versus Radiotherapy in Locally
More informationThe Effect of Treatment Time in Locally Advanced Cervical Cancer in the Era of Concurrent Chemoradiotherapy
The Effect of Treatment Time in Locally Advanced Cervical Cancer in the Era of Concurrent Chemoradiotherapy Suisui Song, MD 1 ; Sonali Rudra, MD 1 ; Michael D. Hasselle, MD 2 ; Paige L. Dorn, MD 1 ; Loren
More informationPatterns of Care in Patients with Cervical Cancer:
Patterns of Care in Patients with Cervical Cancer: Power and Pitfalls of Claims-Based Analysis Grace Smith, MD, PhD, MPH Resident, PGY-5 Department of Radiation Oncology, MD Anderson Cancer Center Acknowledgments
More informationAOGS MAIN RESEARCH ARTICLE
A C TA Obstetricia et Gynecologica AOGS MAIN RESEARCH ARTICLE Differential clinical characteristics, treatment response and prognosis of locally advanced adenocarcinoma/ adenosquamous carcinoma and squamous
More informationCancer Cervix with Brain Metastasis- A rare case from a Rural center of Maharashtra
Case report Cancer Cervix with Brain Metastasis- A rare case from a Rural center of Maharashtra 1 Dr Khushboo Rastogi, 2 Dr Vandana Jain, 3 Dr Darshana Kawale, 4 Dr Siddharth Nagshet, 5 Dr Gopal Pemmaraju
More informationChemotherapy Treatment Algorithms for Urology Cancer
Chemotherapy Treatment Algorithms for Urology Cancer Chemoradiation for bladder cancer; Chemotherapy algorithm for non TCC bladder cancer Squamous cell carcinoma; Chemotherapy Algorithm for Non Transitional
More informationIs Ovarian Preservation Feasible in Early-Stage Adenocarcinoma of the Cervix?
e-issn 1643-3750 DOI: 10.12659/MSM.897291 Received: 2015.12.27 Accepted: 2016.01.13 Published: 2016.02.08 Is Ovarian Preservation Feasible in Early-Stage Adenocarcinoma of the Cervix? Authors Contribution:
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Cancer of the Ovary
North of Scotland Cancer Network Cancer of the Ovary Based on WOSCAN CMG with further extensive consultation within NOSCAN UNCONTROLLED WHEN PRINTED DOCUMENT CONTROL Prepared by NOSCAN Gynaecology Cancer
More informationStaging and Treatment Update for Gynecologic Malignancies
Staging and Treatment Update for Gynecologic Malignancies Bunja Rungruang, MD Medical College of Georgia No disclosures 4 th most common new cases of cancer in women 5 th and 6 th leading cancer deaths
More informationMultivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy
Original Article J Gynecol Oncol Vol. 24, No. 3:222-228 pissn 2005-0380 eissn 2005-0399 Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic
More informationSmall cell carcinoma of the uterine cervix in pregnancy: A case report and review of the literature
ONCOLOGY LETTERS 9: 91-95, 2015 Small cell carcinoma of the uterine cervix in pregnancy: A case report and review of the literature QING WANG 1, YI HONG LIU 1, LI XIE 2, WEN JING HU 2 and BAO RUI LIU 2
More informationRadiation therapy with chemotherapy for patients with cervical cancer and supraclavicular lymph node involvement
Original Article J Gynecol Oncol Vol. 23, No. 3:159-167 pissn 2005-0380 eissn 2005-0399 Radiation therapy with chemotherapy for patients with cervical cancer and supraclavicular lymph node involvement
More informationJ Clin Oncol 22: by American Society of Clinical Oncology INTRODUCTION
VOLUME 22 NUMBER 5 MARCH 1 2004 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Pelvic Irradiation With Concurrent Chemotherapy Versus Pelvic and Para-Aortic Irradiation for High-Risk Cervical
More informationWinship Cancer Institute of Emory University Optimizing First Line Treatment of Advanced Ovarian Cancer
Winship Cancer Institute of Emory University Optimizing First Line Treatment of Advanced Ovarian Cancer Ira R. Horowitz, MD, SM, FACOG, FACS John D. Thompson Professor and Chairman Department of Gynecology
More informationHYPERTHERMIA in CERVIX and VAGINA CANCER. J. van der Zee
HYPERTHERMIA in CERVIX and VAGINA CANCER J. van der Zee ESTRO 2006 Deep hyperthermia in Rotterdam HYPERTHERMIA in CERVIX and VAGINA CANCER ESTRO 2006 Hyperthermia and radiotherapy in primary advanced cervix
More informationConcomitant chemo-radiation in locally advanced carcinoma of the cervix
J Obstet Gynecol India Vol. 57, No. 2: March/April 2007 Pg 145-150 ORIGINAL ARTICLE The Journal of Obstetrics and Gynecology of India Concomitant chemo-radiation in locally advanced carcinoma of the cervix
More informationMRI in Cervix and Endometrial Cancer
28th Congress of the Hungarian Society of Radiologists RCR Session Budapest June 2016 MRI in Cervix and Endometrial Cancer DrSarah Swift St James s University Hospital Leeds, UK Objectives Cervix and endometrial
More informationTable Selected Clinical Trials of Anti-Angiogenesis Therapy in Gynecologic Malignancies
Table Selected Clinical Trials of Anti-Angiogenesis Therapy in Gynecologic Malignancies Uterus Study N Eligibility Regimen RR (No. of Responses) Median OS Grade 3/4 Toxicities Nimeiri et al[42] Total:
More informationCase Scenario 1. History
History Case Scenario 1 A 53 year old white female presented to her primary care physician with post-menopausal vaginal bleeding. The patient is not a smoker and does not use alcohol. She has no family
More informationMedical Therapies in Ovarian Cancer The Arabic Perspectives. Mezghani Bassem -Tunisia
Tunisian Health System: Social Welfare with a Public insurance for all citizens including Indigent persons. (± Additional private insurance) Choice: Public Hospital/Private Clinics (Indigents Public H)
More informationShould the Optimal Adjuvant Treatment for Patients With Early-Stage Endometrial Cancer With High-Intermediate Risk Factors Depend on Tumor Grade?
ORIGINAL STUDY Should the Optimal Adjuvant Treatment for Patients With Early-Stage Endometrial Cancer With High-Intermediate Risk Factors Depend on Tumor Grade? Chunyan Lan, MD,* Xin Huang, MD,* Qidan
More informationCervical CA: What is Advanced Stage? If the tumor is early stage but >4cm (IB2 or IIA2), it is often treated as advanced stage (category 1) but also h
PROGRAMA 2 Taller Internacional Multidisciplinario de Cancer de Mama y Cuello Uterino Racional del tratamiento combinado con Quimioterapia e Irradiación. Resultados en Cáncer de Cérvix avanzado Higinia
More informationMolly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010
LSU HEALTH SCIENCES CENTER NSCLC Guidelines Feist-Weiller Cancer Center Molly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010 Initial Evaluation/Intervention: 1. Pathology Review 2. History and Physical
More informationStudy Title The SACS trial - Phase II Study of Adjuvant Therapy in CarcinoSarcoma of the Uterus
Study Title The SACS trial - Phase II Study of Adjuvant Therapy in CarcinoSarcoma of the Uterus Investigators Dr Bronwyn King, Peter MacCallum Cancer Centre Dr Linda Mileshkin, Peter MacCallum Cancer Centre
More informationPROGNOSTIC FACTORS AND FIRST LINE CHEMOTHERAPY IN AOC
PROGNOSTIC FACTORS AND FIRST LINE CHEMOTHERAPY IN AOC Giorgia Mangili RUF ginecologia oncologica medica IRCCS San Raffaele Milano mangili.giorgia@hsr.it STANDARD CHEMOTHERAPY The standard chemotherapy
More informationClinical Trials. Ovarian Cancer
1.0 0.8 0.6 0.4 0.2 0.0 < 65 years old 65 years old Events Censored Total 128 56 184 73 35 108 0 12 24 36 48 60 72 84 27-10-2012 Ovarian Cancer Stuart M. Lichtman, MD Attending Physician 65+ Clinical Geriatric
More informationOriginal Article. Introduction. Soyi Lim 1, Seok-Ho Lee 2, Kwang Beom Lee 1, Chan-Yong Park 1
Original Article Obstet Gynecol Sci 2016;59(3):184-191 http://dx.doi.org/10.5468/ogs.2016.59.3.184 pissn 2287-8572 eissn 2287-8580 The influence of number of high risk factors on clinical outcomes in patients
More informationCervical Cancer: 2018 FIGO Staging
Cervical Cancer: 2018 FIGO Staging Jonathan S. Berek, MD, MMS Laurie Kraus Lacob Professor Stanford University School of Medicine Director, Stanford Women s Cancer Center Senior Scientific Advisor, Stanford
More informationONCOLOGY REPORTS 28: , 2012
ONCOLOGY REPORTS 28: 487-493, 2012 Phase II study of neoadjuvant chemotherapy with irinotecan hydrochloride and nedaplatin followed by radical hysterectomy for bulky stage Ib2 to IIb, cervical squamous
More informationPrognostic factors and treatment outcome after radiotherapy in cervical cancer patients with isolated para-aortic lymph node metastases
Original Article J Gynecol Oncol Vol. 24, No. 3:229-235 pissn 2005-0380 eissn 2005-0399 Prognostic factors and treatment outcome after radiotherapy in cervical cancer patients with isolated para-aortic
More informationEditorial Process: Submission:09/12/2017 Acceptance:06/19/2018
DOI:10.22034/APJCP.2018.19.10.2745 Concurrent Chemo-Radiobrachytherapy in Cervical Cancer RESEARCH ARTICLE Editorial Process: Submission:09/12/2017 Acceptance:06/19/2018 Concurrent Chemo- Radiobrachytherapy
More informationAdjuvant Chemotherapy in High Risk Patients after Wertheim Hysterectomy 10-year Survivals
6 Adjuvant Chemotherapy in High Risk Patients after Wertheim Hysterectomy 0-year Survivals V Sivanesaratnam,*FAMM, FRCOG, FACS Abstract Although the primary operative mortality following radical hysterectomy
More informationCombined Modality Therapy State of the Art. Everett E. Vokes The University of Chicago
Combined Modality Therapy State of the Art Everett E. Vokes The University of Chicago What we Know Some patients are cured (20%) Induction and concurrent chemoradiotherapy are each superior to radiotherapy
More informationSquamous cell carcinoma arising in a dermoid cyst of the ovary: a case series
DOI: 10.1111/j.1471-0528.2007.01478.x www.blackwellpublishing.com/bjog Gynaecological oncology Squamous cell carcinoma arising in a dermoid cyst of the ovary: a case series JL Hurwitz, a A Fenton, a WG
More informationThe Role of Radiation in the Management of Gynecologic Cancers. Scott Glaser, MD
The Role of Radiation in the Management of Gynecologic Cancers Scott Glaser, MD Nothing to disclose DISCLOSURE Outline The role of radiation in: Endometrial Cancer Adjuvant Medically inoperable Cervical
More informationRole of Twice Weekly HDR- Brachytherapy in Management of Carcinoma Of Uterine Cervix-Experience of Rural Centre in India
Global Journal of Medical research Interdsciplinary Volume 13 Issue 4 Version 1.0 Year 2013 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Inc. (USA) Online
More informationAnalysis of Prognosis and Prognostic Factors of Cervical Adenocarcinoma and Adenosqumous Carcinoma of the Cervix
DOI 10.1007/s11805-009-0133-8 133 Analysis of rognosis and rognostic Factors of Cervical Adenocarcinoma and Adenosqumous Carcinoma of the Cervix Guangwen Yuan Lingying Wu Xiaoguang Li Manni Huang Department
More informationG. Giorda, G. Boz, A. Gadducci, E. Lucia, G. De Piero, A. De Paoli, R. Innocente, M. Trovò, R. Sorio, E. Campagnutta
Multimodality approach in extra cervical locally advanced cervical cancer: chemoradiation, surgery and intraoperative radiation therapy. a phase II trial G. Giorda, G. Boz, A. Gadducci, E. Lucia, G. De
More informationStage III Non-Small Cell Lung Cancer, Is There Any Progress? HARMESH R NAIK, MD. KARMANOS CANCER INSTITUTE 2/24/99
Stage III Non-Small Cell Lung Cancer, Is There Any Progress? HARMESH R NAIK, MD. KARMANOS CANCER INSTITUTE 2/24/99 Introduction 1/3 of the total lung cancer cases few patients are cured with single modality
More informationAuthor's response to reviews
Author's response to reviews Title:Randomized Phase III Trial of Radiotherapy or Chemoradiotherapy With Topotecan and Cisplatin in Intermediate-Risk Cervical Cancer Patients After Radical Hysterectomy
More informationConcurrent Weekly Taxol Versus Weekly Cisplatin with Radiotherapy in the Treatment of Locally Advanced Cervical Cancer
Med. J. Cairo Univ., Vol. 82, No. 2, March: 351-357, 2014 www.medicaljournalofcairouniversity.net Concurrent Weekly Taxol Versus Weekly Cisplatin with Radiotherapy in the Treatment of Locally Advanced
More informationPrognostic significance of positive lymph node number in early cervical cancer
1052 Prognostic significance of positive lymph node number in early cervical cancer JUNG WOO PARK and JONG WOON BAE Department of Obstetrics and Gynecology, Dong A University Hospital, Dong A University
More information