Cisplatin Chemoradiotherapy vs Radiotherapy in FIGO Stage IIIB Squamous Cell Carcinoma of the Uterine Cervix

Shrivastava, Shyamkishore; Mahantshetty, Umesh; Chopra, Supriya; Hawaldar, Ranjana; Hande, Vinod; Kerkar, Rajendra; Maheshwari, Amita; Shylasree, TS; Ghosh, Jaya; Bajpai, Jyoti; Gurram, Lavanya; Gulia, Seema; Gupta, Sudeep

doi:10.1001/jamaoncol.2017.5179

Cited by 136 publications

(87 citation statements)

References 18 publications

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“…Indeed, the further investigation revealed escalated EQD2(point A) was associated with better survival. However, this strategy also introduced much more acute toxicity compared to a recent reported clinical trial result in India [ 23 ], we therefore tried to overcome these complications as previously described [ 24 , 25 ], for example, we prescribed leucogen or rhG-CSF to control hematological toxicity; live Combined Bifidobacterium, Lactobacillus and Enterococcus Capsules were used to rescue intestinal flora as well as sulfasalazine or mesalazine to alleviate intestinal inflammation; when necessary, we applied levofloxacin to control kidney infection. With these measures, the delayed toxicity percentage in our patients was comparable to the Indian study [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Escalated radiation and prophylactic extended field nodal irradiation are beneficial for FIGO IIIB cervical cancer patients’ prognosis

et al. 2018

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BackgroundCurrently, the standard treatment for locally advanced cervical cancer patients is concurrent chemoradiotherapy. Here we aim to evaluate therapeutic efficacy, treatment failure, toxicity and prognostic factors for FIGO IIIB cervical cancer patients.MethodsA comprehensive retrospective analysis was performed to understand various factors which contribute to IIIB cervical cancer prognosis. In total 223 well defined patients were assigned according to their pathological subtype, age, pre-treatment HGB level, tumor size, pelvic lymph node (LN) metastasis, para-aortic LN metastasis as well as external irradiation technologies, treatment duration, point A EQD2 dose and concurrent chemotherapy cycles. We then performed correlation studies of these factors and OS, DFS, LCR, DMFS using univariate and multivariate analysis respectively.ResultsWe managed to achieve 207 (92.8%) complete response (CR) and 16 (7.2%) partial response (PR) with acceptable adverse effects. Notably, the 5 years OS, DFS, LCR, DMFS for these patients were 61.1, 55.2, 83.6 and 66.4% respectively. Importantly, our studies suggest that escalated point A EQD2 can significantly improve OS, DFS and LCR for FIGO IIIB cervical cancer patients, furthermore, patients without para-aortic LN metastasis who received prophylactic extended field irradiation have significant survival advantage for DFS and a tendency to improve OS and DMFS.ConclusionsOur results suggest that FIGO IIIB cervical cancer patients should receive higher EQD2 (≥98Gy10) radiotherapy, moreover, patients without para-aortic LN metastasis should receive prophylactic extended field nodal irradiation to improve prognosis.Electronic supplementary materialThe online version of this article (10.1186/s13014-018-1172-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Escalated radiation and prophylactic extended field nodal irradiation are beneficial for FIGO IIIB cervical cancer patients’ prognosis

et al. 2018

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“…Presence of positive PAN or intra-abdominal spread on CT scan should deter surgeons from contemplating surgical management of these patients. In September 2017, Gupta reported the first phase III randomized trial comparing NACT followed by RH versus CCRT for 633 patients with stage IB2 to IIB squamous cell carcinoma of the cervix ( Shrivastava et al, 2018 ). Pretreatment radiological imaging identified 14% of the patients with a positive pelvic lymph node.…”

Section: Options Of Surgery Concerning Tumor Size and Nodal Statusmentioning

confidence: 99%

Imaging and cancer of the cervix in low- and middle-income countries

Olpin

Chuang

Berek

et al. 2018

Gynecologic Oncology Reports

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Cervix cancer is the fourth most common cancer globally but the second most cancer in women in resource-limited countries. It has remained a clinically-staged neoplasm as per the International Federation of Gynecology and Obstetrics staging classification. As the imaging machines are becoming more available worldwide, the resource-stratified guidelines recommended the inclusion of imaging whenever possible to guide treatment planning. In this report, the utility of imaging in low- and middle-income countries for diagnosis and treatment of cancer of the cervix will be reviewed.

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“…This might be the reasons that 60% responders expressed lack of scientific evidence among existing guidelines In cervix, two thirds of the patients were treated with standard optimal therapy (surgery/chemoradiation). [20,21] One third were given neoadjuvant chemotherapy, to delay surgery, which is not the standard of care at present but is a valid alternative if resources are stretched [22]. With regards to early endometrial cancer, surgery is the main stay of treatment and preferably Minimally Invasive Surgery (MIS), [23] but only one in two received surgery.…”

Section: Resultsmentioning

confidence: 99%

Impact of COVID-19 pandemic on gynecological oncology care: Glimpse into Association of Gynecological Oncologists of India (AGOI) perspective

Bhandoria

Shylasree

Bhandarkar

et al. 2020

Preprint

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Purpose: The notorious COVID 19 pandemic has caused rapid and drastic changes in cancer care all over the world in 2020. This online survey aims to assess the extent to which the pandemic has affected cancer care in gynecological oncology amongst members of Association of Gynecological Oncologists of India (AGOI), a registered professional society, founded in 1991. Methods: We developed and administered a cross-sectional, flash survey to members of The Association of Gynecological Oncologists of India (AGOI) in the first week of April 2020. Data were analyzed using Microsoft Office Excel 2016. Results were expressed as percentages of total responses excluding blank or unattended response. Overall theme-specific responses were expressed as a spectrum of finding and related inferences were drawn.Results: Among approached practitioners, 90 responded to the survey, more than 80 % were practicing consultants and more than 50 % from academic institutions. Results of the survey showed that the ongoing pandemic had severely affected gynecological oncology practice and care amongst all responders. There were modifications in diagnostic pathways, interventions and follow ups across all organ sites. There was near unanimous opinion on use of general safety measures to combat the virus and to use complete PPEs in high risk situation. There was mixed responses to alternative educational activities especially using electronic technology and distant learning methods. There was an optimism among responders with regards to the current situation normalizing in 3 to 6 months. Conclusion: This study documents the pandemic affected scenario of gynecological cancer care and perceptions of Gynecological Oncologists in India. Significant effect on all aspects of cancer care were observed. Technological learning methods both for patient care and educational activities were being adopted by many responders. Keywords: COVID-19, pandemic, gynecological oncology care, survey, AGOI

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Cisplatin Chemoradiotherapy vs Radiotherapy in FIGO Stage IIIB Squamous Cell Carcinoma of the Uterine Cervix

Abstract: clinicaltrials.gov Identifier: NCT00193791.

Cited by 136 publications

References 18 publications

Escalated radiation and prophylactic extended field nodal irradiation are beneficial for FIGO IIIB cervical cancer patients’ prognosis

Escalated radiation and prophylactic extended field nodal irradiation are beneficial for FIGO IIIB cervical cancer patients’ prognosis

Imaging and cancer of the cervix in low- and middle-income countries

Impact of COVID-19 pandemic on gynecological oncology care: Glimpse into Association of Gynecological Oncologists of India (AGOI) perspective

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