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A systematic overview of radiation therapy effects in cervical cancer (cervix uteri)

Published on Jan 1, 2003in Acta Oncologica3.30
· DOI :10.1080/02841860310014660
Nina Einhorn21
Estimated H-index: 21
(KI: Karolinska Institutet),
Claes G. Tropé56
Estimated H-index: 56
+ 3 AuthorsEva Cavallin-Ståhl37
Estimated H-index: 37
(Lund University)
Cite
Abstract
A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately (Acta Oncol 2003; 42: 357-365). This synthesis of the literature on radiation therapy for cervical cancer is based on data from 1 meta-analysis and 34 randomized trials. In total, 35 scientific articles are included, involving 7952 patients. The results were compared with those of a similar overview from 1996 including 34 024 patients. The conclusions reached can be summarized in these points: There are limited scientific data supporting that postoperative pelvic radiotherapy improves disease-free survival in early cervical cancer. No firm conclusion can be drawn. There is moderate scientific evidence that external beam radiotherapy combined with brachytherapy gives a similar disease-free and overall survival rate as radical hysterectomy in early cervical cancer. There is strong scientific evidence that concomitant radiochemotherapy improves disease-free and overall survival compared to radiotherapy alone in early cervical cancer. The NCI has recently published an announcement stating that cisplatin-based chemotherapy should be used concomitantly with radiotherapy in cervical cancer. No solid documentation for this statement can be found concerning locally advanced stages ( >IIB). There is a strong scientific evidence that cisplatin-based chemotherapy given concomitantly with radiotherapy is superior to concomitant chemotherapy with hydroxyurea. There is no scientific evidence to show that neoadjuvant chemotherapy followed by radiotherapy improves disease-free or overall survival compared to radiotherapy alone in patients with localized cervical cancer. There is moderate scientific evidence that high-dose-rate brachytherapy gives the same local control rate as low-dose-rate brachytherapy but with fewer rectal complications. (Less)
  • References (32)
  • Citations (29)
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References32
Newest
Published on Sep 1, 2001in The Lancet59.10
John Green31
Estimated H-index: 31
(University of Liverpool),
John Kirwan3
Estimated H-index: 3
+ 4 AuthorsChris Williams12
Estimated H-index: 12
(Cochrane Collaboration)
Summary Background The US National Cancer Institute alert in February, 1999, stated that concomitant chemotherapy and radiotherapy should be considered for all patients with cervical cancer. Our aim was to review the effects of chemoradiotherapy on overall and progression-free survival, local and distant control, and acute and late toxicity in patients with cervical cancer. Methods With the methodology of the Cochrane Collaboration, we did a systematic review of all known randomised controlled t...
Hiroshi Onishi26
Estimated H-index: 26
,
Motoshi Yamaguchi3
Estimated H-index: 3
+ 11 AuthorsAtsushi Nambu15
Estimated H-index: 15
Abstract The purpose of this study was to explore the effect of concurrent intra-arterial infusion of platinum drugs in patients with stage III or IV uterine cervical cancer treated with radical radiation therapy. Thirty-three patients with advanced (stage IIIA, 2; IIIB, 28; IVA, 3) uterine cervical squamous cell carcinoma were randomized into a concurrent intra-arterial infusion of platinum drugs with radiation therapy (IAPRT) group (18 patients) and a radiation therapy alone group (15 patients...
Published on Nov 1, 1999in Radiotherapy and Oncology5.25
Stanley Dische47
Estimated H-index: 47
(Mount Vernon Hospital),
Michele I. Saunders40
Estimated H-index: 40
(Mount Vernon Hospital)
+ 4 AuthorsSøren M. Bentzen77
Estimated H-index: 77
(Mount Vernon Hospital)
Abstract Background and purpose : A randomised controlled trial of hyperbaric oxygen in the radiotherapy of Stage IIb and III carcinoma of cervix was performed between 1971 and 1980. Apart from an abstract giving an interim report in 1977, results have not been published. Material and methods : In a four arm study, 335 patients were randomised to treatment in 10 or 28 fractions, in hyperbaric oxygen or in air. Data is available concerning 327 cases and this has been analysed. Results : There was...
Faith R. Viswanathan3
Estimated H-index: 3
(Christian Medical College & Hospital),
Cherian Varghese3
Estimated H-index: 3
+ 2 AuthorsViswanathan Perungulam Narayan1
Estimated H-index: 1
(Christian Medical College & Hospital)
Abstract Purpose: Hyperfractionation has been advocated to improve local tumor control by increasing radiation dose without increasing late normal tissue complications. The aim of this study was to determine if hyperfractionation decreased late bowel complications. Methods and Materials: Thirty patients with Stage II and III cervical cancer were randomized to receive either hyperfractionation or conventional fractionation. Patients were followed for 5 years and monitored for tumor control, recur...
Published on Jul 1, 1999in Journal of Clinical Oncology28.25
L. C. Wong1
Estimated H-index: 1
,
H. Y.S. Ngan1
Estimated H-index: 1
+ 3 AuthorsD. T.K. Choy1
Estimated H-index: 1
PURPOSE: Radiotherapy is the standard treatment for locally advanced cervical cancer, but treatment results remain disappointing, particularly for women with bulky central disease. We investigated the role of concurrent chemoradiation and adjuvant chemotherapy in a randomized trial. PATIENTS AND METHODS: Two hundred twenty patients with bulky stage I, II, and III cervical cancer were randomized to receive either standard pelvic radiotherapy or chemoradiation (epirubicin 60 mg/m2) followed by adj...
Published on May 1, 1999in Gynecologic Oncology4.39
M. Lahousen26
Estimated H-index: 26
(University of Graz),
Josef Haas28
Estimated H-index: 28
(University of Graz)
+ 5 AuthorsR. Winter32
Estimated H-index: 32
(University of Graz)
Abstract Background. Adjuvant treatment modalities after radical hysterectomy have long been used in an attempt to eradicate microscopic tumor residuals in patients at high risk for recurrence. However, it has not been clearly demonstrated that adjuvant radiation, adjuvant chemotherapy, or both improve the outcome. To evaluate the effect of adjuvant treatment in patients with high-risk cervical cancer after radical hysterectomy, the Austrian Gynecologic Oncology Group conducted a prospective, ra...
Published on May 1, 1999in Gynecologic Oncology4.39
Alexander Sedlis28
Estimated H-index: 28
(SUNY Downstate Medical Center),
Brian N. Bundy52
Estimated H-index: 52
(Roswell Park Cancer Institute)
+ 3 AuthorsRichard J. Zaino53
Estimated H-index: 53
(Penn State Milton S. Hershey Medical Center)
Abstract Objective. The objective of this study was to evaluate the benefits and risk of adjuvant pelvic radiotherapy aimed at reducing recurrence in women with Stage IB cervical cancer treated by radical hysterectomy and pelvic lymphadenectomy. Methods. Two hundred seventy-seven eligible patients were entered with at least two of the following risk factors: >1/3 stromal invasion, capillary lymphatic space involvement, and large clinical tumor diameter. Of 277 patients, 137 were randomized to pe...
Published on May 1, 1999in Journal of Clinical Oncology28.25
Charles W. Whitney21
Estimated H-index: 21
,
William T. Sause47
Estimated H-index: 47
+ 5 AuthorsShu Yuan Liao10
Estimated H-index: 10
PURPOSE: In 1986, a protocol comparing primary radiation therapy (RT) plus hydroxyurea (HU) to irradiation plus fluorouracil (5-FU) and cisplatin (CF) was activated by the Gynecologic Oncology Group (GOG) for the treatment of patients with locally advanced cervical carcinoma. The goals were to determine the superior chemoradiation regimen and to quantitate the relative toxicities. METHODS: All patients had biopsy-proven invasive squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma...
Published on Apr 15, 1999in The New England Journal of Medicine70.67
Mitchell Morris51
Estimated H-index: 51
(University of Texas MD Anderson Cancer Center),
Patricia J. Eifel53
Estimated H-index: 53
+ 6 AuthorsDavid G. Mutch3
Estimated H-index: 3
(NYU: New York University)
Background and Methods We compared the effect of radiotherapy to a pelvic and para-aortic field with that of pelvic radiation and concurrent chemotherapy with fluorouracil and cisplatin in women with advanced cervical cancer. Between 1990 and 1997, 403 women with advanced cervical cancer confined to the pelvis (stages IIB through IVA or stage IB or IIA with a tumor diameter of at least 5 cm or involvement of pelvic lymph nodes) were randomly assigned to receive either 45 Gy of radiation to the p...
Published on Apr 15, 1999in The New England Journal of Medicine70.67
Maj Henry M. Keys15
Estimated H-index: 15
(Albany Medical College),
Brian N. Bundy52
Estimated H-index: 52
(Roswell Park Cancer Institute)
+ 5 AuthorsDeborah Gersell5
Estimated H-index: 5
Background Bulky stage IB cervical cancers have a poorer prognosis than smaller stage I cervical cancers. For the Gynecologic Oncology Group, we conducted a trial to determine whether weekly infusions of cisplatin during radiotherapy improve progression-free and overall survival among patients with bulky stage IB cervical cancer. Methods Women with bulky stage IB cervical cancers (tumor, ≥4 cm in diameter) were randomly assigned to receive radiotherapy alone or in combination with cisplatin (40 ...
Cited By29
Newest
Published on Jul 1, 2018in Cancer Treatment Reviews8.33
A.J.M. Rombouts4
Estimated H-index: 4
(Radboud University Nijmegen),
Niek Hugen8
Estimated H-index: 8
(Radboud University Nijmegen)
+ 3 AuthorsIris D. Nagtegaal59
Estimated H-index: 59
(Radboud University Nijmegen)
Abstract Background One of the late complications associated with radiation therapy (RT) is a possible increased risk of second cancer. In this systematic review, we analysed the incidence of rectal cancer following primary pelvic cancer irradiation. Methods A literature search was conducted using the PubMed and EMBASE libraries. Original articles that reported on secondary rectal cancer after previous RT for a primary pelvic cancer were included. Sensitivity analyses were performed by correctin...
Published on Jun 1, 2018in Current Urology Reports2.08
James R. Cardinal1
Estimated H-index: 1
(UofU: University of Utah),
Austen Slade1
Estimated H-index: 1
(UofU: University of Utah)
+ 3 AuthorsJeremy B. Myers12
Estimated H-index: 12
(UofU: University of Utah)
Purpose of review To critically review and summarize existing literature assessing the effectiveness of hyperbaric oxygen therapy (HBOT) for the treatment of radiation-induced urologic injury.
Published on Apr 1, 2016in Acta Urológica Portuguesa0.58
Tiago Ribeiro de Oliveira1
Estimated H-index: 1
,
António J. Carmelo Romão1
Estimated H-index: 1
+ 3 AuthorsTomé Lopes4
Estimated H-index: 4
Resumo Objetivo Devido a sua morbilidade e mortalidade consideraveis, a cistite radica hemorragica e uma importante complicacao da radioterapia pelvica, tendo os atuais tratamentos conservadores uma eficacia muito limitada. O oxigenio hiperbarico tem vindo a demonstrar eficacia no tratamento de lesoes induzidas por radiacao, como a cistite radica. Pretende‐se analisar a eficacia e o perfil de seguranca da oxigenoterapia hiperbarica na cistite radica hemorragica refrataria. Material e metodos Ana...
Published on Feb 7, 2016in Physics in Medicine and Biology3.03
Haibin Chen3
Estimated H-index: 3
(Southern Medical University),
Zichun Zhong7
Estimated H-index: 7
(WSU: Wayne State University)
+ 6 AuthorsXuejun Gu22
Estimated H-index: 22
(UTSW: University of Texas Southwestern Medical Center)
GEC-ESTRO guidelines for high dose rate cervical brachytherapy advocate the reporting of the D2cc (the minimum dose received by the maximally exposed 2cc volume) to organs at risk. Due to large interfractional organ motion, reporting of accurate cumulative D2cc over a multifractional course is a non-trivial task requiring deformable image registration and deformable dose summation. To efficiently and accurately describe the point-to-point correspondence of the bladder wall over all treatment fra...
Published on Oct 1, 2015in International Journal of Urology2.11
Tiago Ribeiro de Oliveira1
Estimated H-index: 1
,
António J. Carmelo Romão1
Estimated H-index: 1
+ 1 AuthorsTomé Lopes4
Estimated H-index: 4
Objectives To analyze the efficacy of hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Methods Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated w...
Tara Rosewall16
Estimated H-index: 16
(CSU: Charles Sturt University),
Marc Potvin2
Estimated H-index: 2
(U of T: University of Toronto)
+ 4 AuthorsM. Milosevic58
Estimated H-index: 58
(U of T: University of Toronto)
Abstract Introduction This literature review presents information relevant to medical radiation technologists with respect to new knowledge on the function of the urinary bladder. These new insights are also explored in relation to radiation-induced histopathological effects and the symptoms of bladder dysfunction reported after external beam radiotherapy. Methods and Materials The peer-reviewed scientific literature was examined using various electronic medical search engines with appropriate k...
Published on Aug 1, 2011in American Journal of Obstetrics and Gynecology6.12
Dirk Michael Forner6
Estimated H-index: 6
,
Bjoern Lampe4
Estimated H-index: 4
Objective Whereas pelvic exenteration is an established therapy for the treatment of recurrent cervical carcinoma, it is not often performed for primary locally advanced cervical cancer (LACC). Study Design This retrospective study analyzed survival data and prognostic factors of 35 patients with LACC who were treated by pelvic exenteration. Results After surgery, 33 patients (97%) were macroscopically free of tumor. In 20 patients, pelvic lymph nodes (LN) were involved, and in 6 of these, metas...
Published on Mar 1, 2011in Gynecologic Oncology4.39
G. Macchia21
Estimated H-index: 21
(CUA: The Catholic University of America),
Gabriella Ferrandina54
Estimated H-index: 54
(CUA: The Catholic University of America)
+ 7 AuthorsA.G. Morganti29
Estimated H-index: 29
(CUA: The Catholic University of America)
Abstract Objective A phase I–II prospective clinical trial of adjuvant accelerated radiation therapy (ADA-RT-1 trial) was set up in order to investigate the feasibility and efficacy of a pelvic conformal radiotherapy technique with concomitant boost (CB technique) to the vaginal vault in high-risk uterine cancers. Methods Patients with uterine (endometrial cancer and sarcomas) and cervical neoplasm received external radiotherapy delivered in a short overall treatment time with a CB technique. Th...
Published on Feb 1, 2011in European Journal of Pharmaceutical Sciences3.53
Ioannis I. Verginadis13
Estimated H-index: 13
(UoI: University of Ioannina),
Spyridon Karkabounas10
Estimated H-index: 10
(UoI: University of Ioannina)
+ 5 AuthorsKonstantinos Charalabopoulos24
Estimated H-index: 24
(UoI: University of Ioannina)
Abstract Nowadays, investigation for possible therapeutic applications of various metal-based drugs attracts the scientific interest worldwide. The triorganotin compound bis[triphenyltin(IV)](3-carboxy-pyridine-2-thionato) (SnMNA), was tested for its anti-proliferative and antitumor activities. Cytotoxic activity was assessed by Trypan blue and 3-(4.5-dimethylthiazol-2-yl)-2.5-diphenyltetrazolium bromide assay (MTT). SnMNA exhibited potent cytotoxic effects against leiomyosarcoma cells (LMS) and...
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