Intensity-modulated radiation therapy (IMRT)-based concurrent chemoradiotherapy (CCRT) with Endostar in patients with pelvic locoregional recurrence of cervical cancer

Wang, Huiping; Wang, Zhenqing; Li, Fuqing; Cui, Ying; Ma, Shengchun; Chen, Rui; Wang, Yuhui; Guo, Shul; Wei, Ying

doi:10.1097/md.0000000000021966

Cited by 7 publications

(4 citation statements)

References 36 publications

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“…In the course of radiotherapy, different radiation doses for corresponding target areas may protect normal tissues and increase the local dose of tumors. 16 A study by Liu et al 17 concluded that the IMRT technique boasted of shortening the total treatment time and improving tumor control rate and survival rate without increasing the radiotoxicity of normal tissues. Adverse events frequently associated with this technique included nausea, vomiting, alopecia, neutropenia, and leukopenia, most of which were grade one or two in intensity, with few serious adverse events.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of intensity Modulated Radiation therapy combined with Concurrent Chemoradiotherapy in the treatment of Recurrent Cervical Cancer

Ge¹,

Li²,

Niu³

et al. 2023

Pak J Med Sci

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Objective: To evaluate the clinical value of intensity modulated radiation therapy (IMRT) combined with concurrent chemoradiotherapy in the treatment of recurrent cervical cancer. Methods: This was a retrospective study. Eighty patients with recurrent cervical cancer were recruited and randomly divided into two groups: the experimental group and the control group, with 40 cases in each group at The Fourth Hospital of Hebei Medical University from April, 2017 to April, 2022. Patients in the control group were only given IMRT, while those in the experimental group were given concurrent chemoradiotherapy with paclitaxel and cisplatin based on IMRT. All patients were evaluated for clinical efficacy, adverse drug reactions, and differences in the levels of SCC-Ag, CEA and CA724 and other tumor markers before and after treatment. Results: The total effective rate in the experimental group was significantly better than in the control group (p=0.02). The incidence of adverse reactions was 40% in the experimental group and 32.5% in the control group, with no statistically significant difference (p=0.48). After treatment, the levels of tumor markers in the experimental group were significantly lower than those in the control group, with a statistically significant difference (p=0.00). The three years survival rate was 80% in the experimental group and 55% in the control group (p=0.03). The five years survival rate was 65% in the experimental group and 42.5% in the control group, with a statistically significant difference (p=0.04). Conclusion: Intensity modulated radiation therapy (IMRT) combined with concurrent chemoradiotherapy is a safe and effective regimen for recurrent cervical cancer, boasting significant clinical efficacy, reduced tumor markers, no significant increase in adverse reactions, and significantly improved three-years and five years survival rate. doi: https://doi.org/10.12669/pjms.39.4.6784 How to cite this: Jin G, Li K, Niu S, Fan X, Guo Y. Efficacy and safety of intensity Modulated Radiation therapy combined with Concurrent Chemoradiotherapy in the treatment of Recurrent Cervical Cancer. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.6784 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of intensity Modulated Radiation therapy combined with Concurrent Chemoradiotherapy in the treatment of Recurrent Cervical Cancer

Ge¹,

Li²,

Niu³

et al. 2023

Pak J Med Sci

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“…Endostar was also found to inhibit the expression of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 alpha (HIF-1α) in vivo and in vitro [10]. In another recently published phase II study [11], the objective response rate and disease control rate with intensity-modulated radiation therapy (IMRT)-based CCRT plus Endostar infusions were 67.74% and 83.87%, respectively, supporting the application of this treatment for patients with pelvic locoregional recurrence of cervical cancer following surgical treatment. However, the precise cellular and molecular biological mechanisms underlying these combination therapies remain unknown.…”

Section: Introductionmentioning

confidence: 98%

Endostar Synergizes with Radiotherapy to Inhibit Angiogenesis of Cervical Cancer in a Subcutaneous Xenograft Mouse Model

Xu¹,

Zhao²,

Hu³

et al. 2022

Front. Biosci. (Landmark Ed)

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Background: To investigate the synergic effect and underlying mechanism of Endostar, a recombinant human endostatin used for antiangiogenesis, in radiotherapy for cervical cancer. Methods: The Cell Counting Kit-8 (CCK-8) assay and plate cloning experiment were first employed to analyze the proliferation of HeLa and SiHa cervical cancer cells and human umbilical vein vascular endothelial cells (HUVECs). Flow cytometry was used to detect apoptosis and cell cycle progression. A tube formation assay was used to assess angiogenesis in vitro. The expression of gamma H2A histone family member X (γ-H2AX) and activation of the vascular endothelial growth factor receptor (VEGFR) signaling pathway were detected by immunofluorescence and western blotting, respectively. In a HeLa xenograft model, tumor tissue expression of CD31 and alpha smooth muscle actin and serum expression of VEGF-A were detected by immunohistochemistry (IHC) and enzyme-linked immunosorbent assay, respectively. Results: The CCK-8 and plate cloning assays showed that Endostar and radiotherapy synergistically inhibited the growth of HUVECs but not HeLa and SiHa cells. The flow cytometric results showed that Endostar only promoted radiotherapy-induced apoptosis and G2/M phase arrest in HUVECs (p < 0.05). Endostar combined with radiotherapy also significantly inhibited tube formation by HUVECs (p < 0.05). Furthermore, Endostar inhibited the radiotherapy-induced expression of γH2AX (p < 0.05) and phosphorylation of VEGFR2/PI3K/AKT/DNA-PK in HUVECs (p < 0.05). IHC showed that Endostar enhanced the inhibitory effect of radiotherapy on the microvessel density in xenograft tumor tissues (p < 0.05), as well as serum VEGF-A expression (p < 0.05). The tumor volume in the combination therapy groups (1200 mm 3 ) was significantly lower than in the control group (2500 mm 3 ; p < 0.05). Conclusions: Our findings provide experimental evidence and a theoretical basis for the application of Endostar in combination with irradiation for anti-cervical cancer treatment.

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“…Ordinary two-dimensional ultrasound provides a dynamic evaluation of organ material anatomy during direct scanning. Compared with remaining static imaging techniques (such as magnetic resonance imaging (MRI) detection and computed tomography (CT) detection), its ability to dynamically observe anatomical structures is considered to be the theoretical benefit of ultrasound [8]. At present, three-dimensional ultrasound technology is widely used in clinical practice, and it can display the three-dimensional structure of tissues and organs [9].…”

Section: Introductionmentioning

confidence: 99%

The Value of Three-Dimensional Tomographic Ultrasound Imaging under Backpropagation Algorithm in the Local Staging Diagnosis of Cervical Cancer

Zhang

Tian

et al. 2022

Scientific Programming

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Based on three-dimensional tomographic ultrasound imaging (TUI) of the backpropagation algorithm, this study evaluated the consistency of three-dimensional TUI technology, pelvic examination, and magnetic resonance imaging (MRI) technology in the local staging diagnosis of cervical cancer, aiming to explore the application value of TUI technology in local staging diagnosis of cervical cancer. The backpropagation algorithm was adopted to segment images, and 35 patients who were confirmed to be cervical cancer by tissue biopsy were included in this study. All selected patients underwent transvaginal TUI examination and pelvic MRI examination. Then, the 2010 Federation Internationale of Gynecologie and Obstetrigue (FIGO) was adopted to determine the clinical stage, and the K index and the percentage of consistency were calculated to evaluate the consistency between TUI and MRI. Comparison of tumor size measurements showed that obvious correlation could be found between MRI and three-dimensional TUI (r = 0.842; P < 0.001), MRI, and clinical examination (r = 0.654; P < 0.001) to the assessment of tumor size. In terms of parauterine invasion, there was a moderate consistency between pelvic examination and MRI (K = 0.413; 95% confidential interval (CI) = 0.085–0.762; the overall coincidence rate (OCR) = 78.0%), and there was good consistency between three-dimensional TUI and MRI (K = 0.655, 95% CI = 0.335–0.949; overall coincidence rate = 87.8%). In terms of vaginal infiltration, pelvic examination and MRI showed moderate consistency (K = 0.434; 95% CI = 0.119–0.733; the OCR = 74.2%), and three-dimensional TUI examination and MRI showed excellent consistency (K = 0.568, 95% CI = 0.274–0.881; the OCR = 81.9%). The accuracy of the backpropagation segmentation algorithm was 82%. The results revealed that the three-dimensional TUI technology and MRI showed a good consistency in assessing parauterine invasion of cervical cancer. When the tumor size was evaluated, there was a clear correlation between three-dimensional TUI scans and MRI. Therefore, three-dimensional TUI technology showed relatively high application value for the local stage of cervical cancer.

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Intensity-modulated radiation therapy (IMRT)-based concurrent chemoradiotherapy (CCRT) with Endostar in patients with pelvic locoregional recurrence of cervical cancer

Cited by 7 publications

References 36 publications

Efficacy and safety of intensity Modulated Radiation therapy combined with Concurrent Chemoradiotherapy in the treatment of Recurrent Cervical Cancer

Efficacy and safety of intensity Modulated Radiation therapy combined with Concurrent Chemoradiotherapy in the treatment of Recurrent Cervical Cancer

Endostar Synergizes with Radiotherapy to Inhibit Angiogenesis of Cervical Cancer in a Subcutaneous Xenograft Mouse Model

The Value of Three-Dimensional Tomographic Ultrasound Imaging under Backpropagation Algorithm in the Local Staging Diagnosis of Cervical Cancer

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