Acute and long-term toxicity following radiotherapy alone or in combination with chemotherapy for locally advanced cervical cancer

Maduro, John H.; Pras, Elisabeth; Willemse, Phb; Vries, de Elisabeth G. E.

doi:10.1016/s0305-7372(03)00117-8

Cited by 146 publications

(113 citation statements)

References 140 publications

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“…8,28 Furthermore, radiotherapy may damage the structure of bone and cause osteoporosis. 25,30,31 Finally, the development of osteoporosis is associated with smoking and physical inactivity. 32 In our study, the survivors of gynaecological cancer smoke more and are less physical active, contributing to the increased risk of osteoporosis among gynaecological cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

Self‐reported health and use of health care services in long‐term cancer survivors

Nord

Mykletun

Thorsen

et al. 2004

Intl Journal of Cancer

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Owing to an increasing number of long-term cancer survivors, the use of health care services and somatic health problems were compared between cancer survivors and a noncancer population. Data from the Nord-Trøndelag Health Survey 2 (HUNT 2, 1995-1997) was merged with the Cancer Registry of Norway. Six cancer subgroups were constructed with diagnosis 5 years prior HUNT 2: testicular cancer (n‫؍‬ 59), colorectal cancer (n‫؍‬ 175), prostate cancer (n‫؍‬ 87), breast cancer (n‫؍‬ 258), gynaecological cancer (n‫؍‬ 153) and lymphoma/leukaemia (n‫؍‬ 83). For each cancer survivor 3 matched noncancer controls were selected from the HUNT 2 survey. The prevalence of common health problems, use of health care services and unfavourably life style parameters were compared between the 2 groups. Cancer survivors used health care services and received social welfare benefits more often than the controls. There was an increased risk of perceiving poor health after a history of cancer. In the recent decade, the incidence of most malignancies has increased, as well as 5-year survival rates in both men and women. 1 During 1992-1996, the relative overall 5-year survival rate for all cancer patients in Norway was, respectively, 50% in males and 58%; in females compared to 25% in males and 38%; in females for the period 1957-1961. In 1999, a total of 83,636 cancer survivors with an at-least 5-year survival were alive in Norway. 1 These figures have in the last few years led to a paradigm shift: cancer should not only be considered an acute or terminal event but should likewise be viewed as a chronic condition. Quality of life and long-term effects after cancer therapy have therefore become important outcome parameters to be considered by oncologists, cancer surgeons and primary health care officers.Cancer represents a heterogeneous group of diagnoses where treatment and aetiology are far from uniform. The cancer itself and its treatment may affect the long-term health of cancer survivors at various degrees, causing adverse health conditions, which differ from those observed in the age-matched noncancer population. The recognition of common health problems reducing the overall well being among cancer survivors is of importance in order to identify these individuals' specific needs when presented to the health care service. Furthermore the recognition of long-term effects of treatment may lead to reconsideration and eventual modification of current treatment strategies.Several reports have focused on long-term medical effects after treatment for childhood cancer as well as adulthood cancer and have described specific health problems related to different treatment modalities. 2,3,4 -9 Beside causing chronic health conditions, cancer and its treatment increase the risk of secondary malignancies. 10 -13 Owing to the increased risk of developing secondary tumours and chronic diseases after treatment for malignancies, cancer survivors represent an important target population for health promotion interventions. Few studies regarding long-te...

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Section: Discussionmentioning

confidence: 99%

Self‐reported health and use of health care services in long‐term cancer survivors

Nord

Mykletun

Thorsen

et al. 2004

Intl Journal of Cancer

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“…Responses to neoadjuvant radio/chemotherapy vary greatly in patients (2,3). Intrinsic and acquired resistance of the neoplastic cells as well as substantial side effects from standard treatment including platinum-based chemotherapy limit the options for escalation (4). Identification of patients that may best benefit from chemotherapy would be useful for improved clinical management.…”

Section: Introductionmentioning

confidence: 99%

STAT3/IRF1 Pathway Activation Sensitizes Cervical Cancer Cells to Chemotherapeutic Drugs

et al. 2016

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Neoadjuvant radio/chemotherapy regimens can markedly improve cervical cancer outcome in a subset of patients, while other patients show poor responses, but may encounter severe adverse effects. Thus, there is a strong need for predictive biomarkers to improve clinical management of cervical cancer patients. STAT3 is considered as a critical antiapoptotic factor in various malignancies. We therefore investigated STAT3 activation during cervical carcinogenesis and its impact on the response of cervical cancer cells to chemotherapeutic drugs. Tyr705-phosphorylated STAT3 increased from lowgrade cervical intraepithelial neoplasia (CIN1) to precancerous CIN3 lesions. Notably, pTyr705-STAT3 activation significantly declined from CIN3 to invasive cancer, also when compared in the same clinical biopsy. pTyr705-STAT3 was also low or absent in cultured human cervical cancer cell lines, consistent with the in vivo expression data. Unexpectedly, IL6-type cytokine signaling inducing STAT3 activation rendered cervical cancer cells significantly more susceptible to chemotherapeutic drugs, that is, cisplatin or etoposide. This chemosensitization was STAT3-dependent and we identified IFN regulatory factor-1 (IRF1) as the STAT3-inducible mediator required for cell death enhancement. In line with these data, pTyr705-STAT3 significantly correlated with nuclear IRF1 expression in cervical cancer in vivo. Importantly, high IRF1 expression in pretreatment cervical cancer biopsy cells was associated with a significantly better response to neoadjuvant radio/chemotherapy of the patients. In summary, our study has identified a key role of the STAT3/IRF1 pathway for chemosensitization in cervical cancer. Our results suggest that pretherapeutic IRF1 expression should be evaluated as a novel predictive biomarker for neoadjuvant radio/chemotherapy responses. Cancer Res; 76(13); 3872-83. Ó2016 AACR.

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“…Although extensive literature is available on the acute morbidity due to chemoradiotherapy in women with cancer cervix, most of the studies have been done at carefully prepared academic centers in developed countries (Rose et al, 1999;Maduro et al, 2003;Ikushima et al, 2006;Mahantshetty et al, 2010;Khalid et al, 2012). Socially disadvantaged women in less developed countries of the world may be more susceptible to the combined treatment's toxic effects due to poor nutritional status, presence of comorbid chronic conditions and of difficulties in accessing medical care during treatment.…”

Section: Introductionmentioning

confidence: 99%

Chemoradiation Related Acute Morbidity in Carcinoma Cervix and Correlation with Hematologic Toxicity: A South Indian Prospective Study

Kumaran

Guruvare

Sharan

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Purpose: To assess chemoradiation related acute morbidity in women with carcinoma cervix and to find and correlation between hematologic toxicity and organ system specific damage. The toxicities were most severe in 3 rd and 5 th week. All women could complete radiotherapy except two due to causes unrelated to radiation morbidity; seven (8.86%) had to discontinue chemotherapy due to leukopenia and intractable diarrhea. Though there was no correlation between anemia and other toxicities, it was found that all with leukopenia had diarrhea. Conclusions: Chemoradiation for cancer cervix is on the whole well tolerated. Leukopenia and severe diarrhea were the acute toxicities that compelled discontinuation of chemotherapy in two women. Though anemia had no correlation with gastrointestinal toxicity, all of those with leukopenia had diarrhea. is any correlation between hematologic toxicity and organ system specific toxicity. Keywords

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Acute and long-term toxicity following radiotherapy alone or in combination with chemotherapy for locally advanced cervical cancer

Cited by 146 publications

References 140 publications

Self‐reported health and use of health care services in long‐term cancer survivors

Self‐reported health and use of health care services in long‐term cancer survivors

STAT3/IRF1 Pathway Activation Sensitizes Cervical Cancer Cells to Chemotherapeutic Drugs

Chemoradiation Related Acute Morbidity in Carcinoma Cervix and Correlation with Hematologic Toxicity: A South Indian Prospective Study

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