Total radiation dose and overall treatment time are predictive for tumor sterilization in cervical carcinoma treated with chemoradiation and pulsed-dose-rate brachytherapy

Krebs, Lorraine; Maillard, Sophie; Gaillot-Petit, N.; Ortholan, C.; Nguyen, Tan Dat

doi:10.1016/j.brachy.2014.08.051

Cited by 11 publications

(14 citation statements)

References 41 publications

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“…If the diagnosis is made in the first two trimesters of gestation, the continuation of pregnancy for many weeks would lead to a significant delay in the commencement of treatment, worsening the prognosis; therefore it is recommended to terminate the pregnancy and commence treatment urgently. Given the immense progress of perinatology, if cervical cancer is diagnosed at the end of the second trimester of gestation (week [23][24], the therapeutic decisions must be individualised and based on the evaluation of the clinical situation and the possibilities of the institution [22]. In the study group, in the cases when cervical cancer was diagnosed in the second trimester, it was decided to terminate the pregnancy and to begin oncological treatment as fast as possible.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy-related cervical cancer in the material of the Regional Cancer Centre, Łódź, between 2011 and 2014

Danielska¹,

Moszyńska-Zielińska²,

Gottwald³

et al. 2017

Nowotwory. Journal of Oncology

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Introduction. Pregnancy-related cancer is defined as cancer diagnosed during pregnancy or in the first postpartum year. Cervical cancer affects approximately 1 in 1000 pregnant women and is the most common malignancy affecting pregnancy. We retrospectively analysed the clinical outcome and results of treatment in patients with pregnancy--related cervical cancer. Material and methods. We retrospectively analysed the medical records of nine patients with invasive cervical cancer diagnosed during pregnancy and the postpartum period who had been treated in the Regional Oncological Centre, Łódź, between 2011-2014. Results. Three patients with cervical cancer at stage I were diagnosed between the 14 th and 17 th week of pregnancy afterwards and underwent radical surgery. Two patients with cervical cancer at stage Ib who were diagnosed in the 19 th and 24 th week of gestation decided to continue pregnancy until the 30 th and 32 nd week; then a cesarean section combined with radical surgery was performed. In three patients with inoperative cervical cancer diagnosed between the 26 th and 28 th week of pregnancy, a cesarean section was performed at week 30-32. In one patient cervical cancer at stage IIb was diagnosed during the post-partum period. All patients were treated using intensity-modulated radiotherapy (IMRT) to a total dose of 44 Gy/2Gy, weekly cisplatin (40 mg/m 2 ) concurrent with radiotherapy and brachytherapy. No toxicity was observed. During follow-up, two patients with inoperable cervical cancer were diagnosed with a recurrence 2 and 10 months after treatment, respectively. Conclusions. The management of pregnancy-related cervical cancer is mainly determined by the week of the pregnancy and the stage of the disease at diagnosis, but also by the patient choice. The general condition and follow-up of newborns from pregnancies complicated by cervical cancer are similar to those of newborns arising from non--complicated pregnancies. Treatment toxicity is similar in cases with pregnancy-related cervical cancer and in non--pregnant women with cervical cancer. The major prognostic factor in pregnancy-related cervical cancer remains the stage of the disease at diagnosis. NOWOTWORY J Oncol 2016; 66, 5: 359-366

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Section: Discussionmentioning

confidence: 99%

Pregnancy-related cervical cancer in the material of the Regional Cancer Centre, Łódź, between 2011 and 2014

Danielska¹,

Moszyńska-Zielińska²,

Gottwald³

et al. 2017

Nowotwory. Journal of Oncology

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“…A study from France (Krebs et al, 2015) showed that overall treatment duration is as important as dose to the high risk clinical target volume to achieve complete response in cervical cancer. However Song et al (2013) showed a paradoxical result.…”

Section: Discussionmentioning

confidence: 99%

“…Shorter duration of treatment did not result in higher toxicity which is in contrary to the finding by other study (Erridge et al, 2002).The possible explanation of our finding could be due to conventional fraction size practiced in the study. The current study aimed comparative evaluation of two treatment regimen using conventional fractionation and concurrent chemotherapy and thus differs from most of the above studies which evaluated its efficacy with altered fractionation (Erridge et al, 2002;Krebs et al, 2015). The homogenous study population, randomized treatment allocation and prospective evaluation are the strengths of the study when compared to some other contemporary studies, which are mostly retrospective in nature (Erridge et al, 2002;Song et al, 2013), with a heterogeneous study population and varied treatment techniques.…”

Section: Discussionmentioning

confidence: 99%

Impact of Treatment Time on Chemoradiotherapy in Locally Advanced Cervical Carcinoma

Pathy

Kumar²,

Pandey³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…However, a spread of more than 56 days is a pejorative prognostic factor for LCR and OS in several published studies (Krebs et al, 2015, Perez et al, 1995, Fyles et al, 1992, Chen, Liang, Yang, Ko & Lin, 2003. Finally, among the 22 patients treated with CRT, a dose-intensity reduction in platinum dose was observed in 10 of the 14 evaluable patients (missing data).…”

Section: Difficulties Of Treatment and Loss Of Chancementioning

confidence: 99%

“…The total doses of EBRT, LDR or HDR were calculated using the Equivalence software developed by the GEC-ESTRO with the Embrace protocol (EMBRACE). Overall treatment time recommended was 56 days or less (Krebs, Maillard, Gaillot-Petit, Ortholan & Nguyen, 2015, Perez, Grigsby, Castro-Vita, &Lockett, 1995, Fyles, Keane, Barton & Simm, 1992.…”

Section: Brachytherapymentioning

confidence: 99%

Outcomes after Radiation Therapy for HIV Positive Patients with Invasive Cervical Cancer

Molinier¹,

Huguet²,

Ballester³

et al. 2018

CCO

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Objective: To assess tolerance, local control, and survival outcomes for HIV (human immunodeficiency virus) positive patients with locally advanced cervical cancer (CC) treated with external beam radiation therapy (EBRT) and/or brachytherapy from an Assistance Publique -Hôpitaux de Paris (APHP) retrospective cohort. Methods:Between 2000 and 2014, 28 HIV positive patients presenting with a non-metastatic CC were treated in one of the five APHP radiation therapy centers. Fifteen patients (54%) underwent primary surgery. Twenty-four patients (88%) received EBRT, with concurrent chemotherapy in 22 cases, and 68% received brachytherapy. Results:The median follow-up was 58 months. At 5 years, local control (LCR) and overall survival rates (OS) were 56% and 46.5% respectively. A grade 3-4 acute toxicity (mainly hematological toxicity) was reported in 18 patients (64%). In univariate analysis, total irradiation dose (p=0.03) and cisplatin-based chemotherapy (p=0.005) were predictive of acute toxicity. A grade 3-4 late toxicity (mainly gastro-intestinal and renal) was observed in 7 patients (25%). In univariate analysis, HIV stage at diagnosis (p=0.02) and an initial CD4 count <200/mm3 (p=0.03) were predictive factors of late toxicity. Conclusion:In this study including HIV positive patients with CC, local control and overall survival rates seemed to be lower than those reported in the literature for non-HIV patients. We also reported an increase in acute and late toxicity, mainly hematological, underlying the fundamental role of immunosuppression in tolerance to radiation therapy.

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Total radiation dose and overall treatment time are predictive for tumor sterilization in cervical carcinoma treated with chemoradiation and pulsed-dose-rate brachytherapy

Cited by 11 publications

References 41 publications

Pregnancy-related cervical cancer in the material of the Regional Cancer Centre, Łódź, between 2011 and 2014

Pregnancy-related cervical cancer in the material of the Regional Cancer Centre, Łódź, between 2011 and 2014

Impact of Treatment Time on Chemoradiotherapy in Locally Advanced Cervical Carcinoma

Outcomes after Radiation Therapy for HIV Positive Patients with Invasive Cervical Cancer

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