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NCI CANCERLIT® Search: Therapy of Cervical Cancer - February 2002
National Cancer Institute®
Ultima Vez Modificado: 1 de febrero del 2002
Table of Contents
1
UI - 11521790
AU - Tattersall MH
TI -
Chemotherapy in cervical cancer: is cisplatin alone still the standard
of care?
SO - Ann Oncol 2001 Jul;12(7):883
2
UI - 11815967
AU - Hareyama M; Sakata K; Oouchi A; Nagakura H; Shido M; Someya M; Koito K
TI -
High-dose-rate versus low-dose-rate intracavitary therapy for carcinoma
of the uterine cervix: a randomized trial.
SO - Cancer 2002 Jan 1;94(1):117-24
AD - Department of Radiology, Sapporo Medical University, School of Medicine,
Sapporo, Japan. hareyama@sapmed.ac.jp
BACKGROUND: This was a prospective randomized clinical trial undertaken
at our institution to compare low-dose-rate (LDR) intracavitary
radiation therapy versus high-dose-rate (HDR) intracavitary radiation
therapy for the treatment of cervical carcinoma. METHODS: From January
invasive carcinoma of the uterine cervix were entered into this
randomized study. Treatment arm by HDR or LDR was allocated according to
the month of each patient's birth. External irradiation consisted of
whole pelvis irradiation and pelvic irradiation. Doses of external
irradiation for both groups were identical. The authors used 0.588 as
the conversion factor of total intracavitary dose from LDR to HDR.
RESULTS: The 5-year disease specific survival rates of Stage II and III
patients treated with HDR were 69% and 51% whereas those with LDR were
87% and 60%, respectively. The 5-year pelvic recurrence free survival
rates of Stage II and III patients treated with HDR were 89% and 73%
whereas those with LDR were 100% and 70%, respectively. There was no
significant difference in disease specific survival or pelvic recurrence
free survival rates between HDR and LDR. The actuarial complication rate
(Radiation Therapy Oncology Group Grade 3, 4, or 5) at 5 years was 10%
in the HDR group and 13% in the LDR group, and the difference between
the HDR and LDR groups was not statistically significant. CONCLUSIONS:
The pelvic control or actuarial complication rates were comparable
between HDR and LDR treatment. The difference between the disease
specific survival rates for HDR and LDR was not statistically
significant for Stage II or III, although in Stage II, patients treated
with LDR appeared to have a better survival rate than those treated with
HDR. Copyright 2002 American Cancer Society.
3
UI - 11561680
AU - Rajdev L; Yu ZF; Wadler S; Weller E; Kahn SB; Tormey D; Skeel R; Wiernik
TI -
PH
N-Methylformamide in advanced squamous cancer of the uterine cervix: an
Eastern Cooperative Oncology Group phase II trial.
SO - Invest New Drugs 2001;19(3):233-7
AD - Albert Einstein Cancer Center, Bronx, NY, USA.
PURPOSE: Preclinical and clinical data support the study of polar-planar
compounds such as N-Methylformamide (NMF) in advanced squamous cell
carcinoma of the uterine cervix (SCC). This phase II trial sought to
determine the efficacy and toxicities of NMF in patients with advanced
SCC. PATIENTS AND METHODS: Eligibility for this trial required
bidimensionally measurable squamous or adenosquamous cell cancer of the
uterine cervix incurable by surgery or radiation therapy, ECOG
performance status of < or = 2, no prior NMF and no more than one prior
chemotherapy regimen. Patients received NMF at 2000 mg/m2 intravenously
over 15-30 minutes days 1, 8 and 15. The cycle was repeated every 42
days. A single dose escalation of 25%, 500 mg/m2 was made after the
first cycle if the toxicities did not exceed grade I for hepatic
carcinoma of the uterine cervix were entered on study. Two patients were
ineligible because there was no pretreatment SGOT on one and the other
deteriorated prior to drug approval. Therefore, 19 patients were include
in the analysis of response and survival. Four were inevaluable, three
due to inappropriate tumor evaluation and one secondary to grade III
vomiting, who went off study. These patients were included in the
denominator while computing the results. There were 2 deaths, one due to
pulmonary hemorrhage from perforation during central venous insertion
and one due to disease. 30% (6/19) patients had toxicities, Eastern
Cooperative Oncology Group (ECOG) grade III or higher and 2 of these
patients suffered multiple grade III toxicities. There were no complete
or partial responses. CONCLUSION: In this population, NMF in the dose
and schedule employed exhibited no clinical activity.
4
UI - 11792612
AU - Charvolin JY; Nos C; Rochefordiere Ade L; Margerie VJ; Durand JC; Clough
TI -
KB
[Relevance of combined radiation and surgical treatment of early
invasive carcinoma of the cervix]
SO - Bull Cancer 2001 Dec;88(12):1207-12
AD - Service de chirurgie, Institut Curie, 25, rue d'Ulm, 75005 Paris,
France. charvolin.jean-yves@ghicl.fupl.asso.fr
The aim of this study was to assess the result and the postherapeutic
complications rates of preoperative radiation therapy and radical
surgery in association, for stage IB to IIB cervical carcinoma. For 1983
to 1990, 314 patients were treated at the Institut Curie for stage IB to
IIB cervical carcinoma. For small lesions, less than 4 cm, preoperative
uterovaginal brachytherapy was performed (60 to 65 Gy), followed, 6
weeks later, by a modified radical hysterectomy (Piver type 2) with
pelvic lymphadenectomy. Larger tumors were treated with pelvic
radiotherapy (36 Gy), then by brachytherapy (30 Gy), followed, 6 weeks
later, by the same surgical procedure. 82% of the tumors were 4 cm or
smaller. 64% of tumors were completely sterilised by the preoperative
radiation. 5 and 10-year actuarial survival rates were respectively 81%
and 70 %. 5-year actuarial survival rate was 87.5% for stage I and 63%
for stage II patients. 5-year local disease free survival rate was 88%
for stage I and 73% for stage II patients. All complications were
prospectively recorded. The early post operative complication rate was
6.3%, with no urinary complications. The late complication rate was
3.3%, mainly grade 2 sequelae. No ureteral fistulas were observed. By
combined preoperative radiotherapy and surgery, adapting the dosimetry
and the radicality of the procedure, we obtained cure rates and
recurrence rates identical to those obtained with exclusive surgery or
radiotherapy alone. However, the complication rate of the association of
both adapted treatments, has considerably reduced the early and late
complication rate.
5
UI - 11724256
AU - Andrieu MN; Edinsel H; Kurtman C
TI -
Early results of exclusive radiotherapy in advanced stage cervical
carcinoma performed with reference to ICRU Report 38.
SO - Radiat Med 2001 Sep-Oct;19(5):255-61
AD - Radiation Oncology Department, Medical School of Ankara University,
Turkey.
BACKGROUND AND PURPOSE: Most of the studies in which medium dose rate
(MDR) or high dose rate (HDR) brachytherapy have been used for the
treatment of cervical carcinoma were prescribed according to the
Manchester system. This study aims to present early results of exclusive
radiotherapy, which includes MDR brachytherapy, performed using ICRU 38
recommendations to their full extent. MATERIALS AND METHODS: Between
1994 and 1997, 80 patients with advanced stage (FIGO stages IIA-IVA)
cervical carcinoma received external beam therapy (EBT) to the pelvis at
a total dose of 46 to 50 Gy and two fractions of MDR (approximately 11.5
Gy/h) brachytherapy delivered to the 60 Gy reference isodose. A dose
correction factor of 0.80 was used for dose rate effect. Additionally,
10-14 Gy EBT was given as a parametrial boost. Mean follow-up duration
was 25.7 months. RESULTS: Local control (LC) and 3-year overall survival
were 63% and 68%, respectively, for all patients. For stages II, III,
and IV, LC was 75%, 44%, and 60% and 3-year survival was 75%, 62%, and
50%, respectively. Seven patients had severe late complications (8.7%).
CONCLUSIONS: The results of this study encourage the use of ICRU 38
recommendations with MDR or HDR brachytherapy with some additional
measures in terms of the radiobiological aspect.
6
UI - 11705848
AU - Follen M; Atkinson EN; Schottenfeld D; Malpica A; West L; Lippman S; Zou
TI -
C; Hittelman WN; Lotan R; Hong WK
A randomized clinical trial of 4-hydroxyphenylretinamide for high-grade
squamous intraepithelial lesions of the cervix.
SO - Clin Cancer Res 2001 Nov;7(11):3356-65
AD - Department of Gynecologic Oncology, The University of Texas M. D.
Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
mfollen@mdanderson.org.
PURPOSE: Previous trials of topical trans-retinoic acid treatment of
cervical intraepithelial neoplasia (CIN) grades 2 and 3 led to a
statistically significant regression of CIN 2, but not CIN 3. We tested
N-(4-hydroxyphenyl)retinamide (4-HPR), a promising oral retinoid that
has been shown to induce apoptosis through nonretinoic receptor
acid-mediated pathways, for its toxicity and efficacy against CIN 2/3.
EXPERIMENTAL DESIGN: In a blinded randomized trial, 4-HPR at 200 mg/day
for 6 months (with a 3-day/month drug holiday) was compared with placebo
in patients with biopsy-proven CIN-2/3 [high-grade squamous
intraepithelial lesions (HGSILs)]. Patients were treated with placebo or
4-HPR for 6 months, biopsied, and then followed for an additional 6
months. At the 12-month end point, they underwent either loop excision
if a histological lesion was present or a biopsy from the original area
of the lesion if no lesion was present. RESULTS: An interim analysis of
blinded data showed a significantly worse prognosis at 12 months for one
group. When the code was broken because of the poorer outcomes, we
discovered that the 4-HPR treatment arm was performing more poorly than
was the placebo at 6 and 12 months (25 versus 44% response rates at 6
months; 14 versus 50% at 12 months). Toxicity was not significant in
either arm. CONCLUSIONS: 4-HPR at 200 mg/day with a 3-day/month drug
holiday is not active compared with placebo in the treatment of HGSIL.
Because 4-HPR is active in the laboratory, the lack of effect in our
trial may indicate that higher doses are needed in patients to achieve
comparable results.
7
UI - 11756723
AU - Otake S; Mayr NA; Ueda T; Magnotta VA; Yuh WT
TI -
Radiation-induced changes in MR signal intensity and contrast
enhancement of lumbosacral vertebrae: do changes occur only inside the
radiation therapy field?
SO - Radiology 2002 Jan;222(1):179-83
AD - Department of Radiology, University of Iowa Hospitals and Clinics, Iowa
City, IA, USA.
PURPOSE: To evaluate temporal changes in signal intensity (SI) and
degree of contrast enhancement (CE) of bone marrow in lumbosacral
vertebrae inside and outside the radiation therapy (RT) field. MATERIALS
AND METHODS: Twenty-three patients with advanced uterine cervical cancer
who were treated with RT were prospectively evaluated. Each patient
underwent four dynamic magnetic resonance (MR) studies: before RT, 2 and
4 weeks after initiation of RT, and 4 weeks after completion of RT. SI
and CE were calculated in all four studies of each patient. RESULTS:
Bone marrow inside the RT field showed steady and marked increase in
precontrast SI and early and transient increase in CE at 2 weeks after
initiation of RT followed by progressive and marked decrease in CE at 4
weeks after initiation of RT and 4 weeks after completion of RT. Bone
marrow outside the RT field showed slight increase in precontrast SI and
steady and moderate decrease in CE to a lesser degree without early
increase as seen in bone marrow inside the RT field. CONCLUSION: RT
causes an increase in precontrast SI predominantly in bone marrow inside
the RT field. However, a decrease in CE is seen in bone marrow not only
inside but also outside the RT field.
8
UI - 11826504
AU - Bagrova SG
TI -
[Results of phase II clinical trial of cycloplatam in refractory solid
tumors]
SO - Vopr Onkol 2001;47(6):752-6
AD - N.N. Blokhin Center for Oncology Research, Russian Academy of Medical
Sciences, Moscow.
Cycloplatam, a new platinum derivative, evolved at N.S. Kurnakov
Institute of General and Inorganic Chemistry in 1982, has been added to
the arsenal of Russian cytostatic drugs. Having passed phase I trials,
it was approved for treatment of pleural mesothelioma, ovarian carcinoma
and multiple myeloma. Leukothrombocytopenia formation indicates
toxicity-related limit of dosage. Phase II clinical trials are under way
at the Center. They include treatment of solid tumors with cycloplatam
alone in urinary bladder tumors, cervical carcinoma and malignant
pleurites of various etiology as well as in combination with other
cytostatics (carcinoma of the prostate, pleural mesothelioma and urinary
bladder tumors). The drug may be recommended both for oral and
intracavitary administration; side-effects may include moderate
toxicity, chiefly, hematological one.
9
UI - 11793289
AU - Schmitt J; Abolmaali ND; Holler U; Schiemann M; Obert K; Jacobi V; Vogl
TI -
TJ
MR imaging characteristics of osteoradionecrosis of the pelvis after
radiation therapy on gynecological tumors.
SO - Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2002 Jan;174(1):76-81
AD - Institut fur Diagnostische u. Interventionelle Radiologie, Klinikum der
J. W. Goethe-Universitat, Frankfurt, Germany. jan.schmitt@kgu.de
PURPOSE: To describe MR imaging characteristics of osteoradionecrosis
(ORN) of the pelvis as a result of radiation therapy (RT) on
gynecological tumors. MATERIAL AND METHODS: Radiography, computed
tomography (CT) and magnetic resonance imaging (MRI) were performed on 9
women (mean age 67.5 years) with gynecological tumors to identify ORN.
T1- and T2-weighted sequences and contrast-enhanced t1-weighted
sequences with and without fat saturation were used. The patients began
developing pain after the completion of RT indicating a possible ORN a
which time MRI was performed. MR images were correlated with the results
of clinical examinations. RESULTS: Depending on the time elapsed after
RT, ORN presented with different signal intensities. The acquired images
suggested that signal changes in T2-weighted images as well as the
different enhancement behaviour of ORN could be dependent on the time
elapsed after RT. Visualisation of the affected regions was best
achieved with fat-saturated T1-weighted sequences. CT showed increased
density in the affected regions corresponding to osteosclerosis. In all
cases the sacroiliac joint was affected, some times bilaterally.
CONCLUSION: MRI is helpful in detecting and characterizing ORN. Changes
in signal intensity, based on histopathological tissue changes could
make a chronological classification possible.
10
UI - 11830237
AU - Willemse PH; de Vries EG; Pras E; Maduro JH
TI -
Treatment of cervical cancer.
SO - Lancet 2002 Jan 26;359(9303):357-8
11
UI - 11830236
AU - van der Zee J; Koper PC; Lutgens LC; Burger CW
TI -
Treatment of cervical.
SO - Lancet 2002 Jan 26;359(9303):357; discussion 358
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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