A phase I-II trial of multimodality management of bulky gynecologic malignancy: Combined chemoradiosensitization and radiotherapy

Abstract

Between December 1983 and December 1987, there were 44 patients with bulky, nonresectable squamous cell carcinomas of the gynecologic tract (cervix, 36; vagina, eight) who were treated with concomitant chemotherapy and radiotherapy. Chemotherapy consisted of 5-fluorouracil (5-FU) 1g/m2 given by continuous intravenous infusion on days 1 through 4 and mitomycin C 10 mg/m2 given intravenously on day 1. External-beam irradiation was started on day 1 with a total calculated dose of 5000 cGy in 25 fractions employed. This was followed by brachytherapy. With a mean follow-up of 30.3 months and a median of 28 months, local control has been achieved in 32 of 44 patients (73%). The overall response rate was 88% (3-month partial response, 43%; 3-month complete response, 45%; 8-month partial response, 15%; 8-month complete response, 73%). Analysis of complications by Radiation Therapy Oncology Group (RTOG) criteria did not demonstrate an increase in acute or late complications.

Status of Circulating Lipid Profile in Human Uterine Cervical Carcinoma before and after Therapy.

“…Lipid components and lipid-bound sialic acid levels were brought back to normal after chemoradiotherapy (Tables 1-3). High response rate was achieved by the combination therapy of 5-fluorouracil and mitomycin in the carcinoma of the gynecological tract [20]. Tumor resection with subsequent normalization of the elevated cholesterol and triglyceride levels has also been reported [21].…”

Radiation Enterocolitis: Overview of the Past 15 Years

“…These findings must be reevaluated, however, because in recent years gynecologists are increasingly using combined chemotherapy with irradiation after surgery, which has so far proved to be effective [1,2]. As a result, the dose of radiation can be expected to further decrease.…”

“…In the former group, 5 of 18 patients died of bleeding from the remaining intestine after operation. We concluded that surgical resection of the diseased intestine is a useful procedure for treating radiation enterocolitis to reduce intestinal bleeding from the irradiated intestine.Radiation enterocolitis often results from radiotherapy, which is used for the treatment of various gynecologic malignancies in combination with other therapeutic modalities such as chemotherapy or surgery [1,2]. In the worst cases, patients require surgery because of intestinal obstruction or bleeding.…”

Interim results of a randomized trial of mitomycin C as an adjunct to radical radiotherapy in the treatment of locally advanced squamous-cell carcinoma of the cervix

“…Based on the successful treatment of anal cancer with radiation, 5-fluorouracil, and mitomycin C, there have been multiple phase I/II trials published for locally advanced cervix cancer using a similar treatment strategy [63,[73][74][75][76][77][78][79][80]. With trial designs lacking a randomization between experimental and control treatments and some with small numbers of patients, these reports are inconclusive, although comparisons with same institution historical control populations have suggested improved local control and perhaps survival.…”