Tumor Size, Irradiation Dose, and Long-Term Outcome of Carcinoma of Uterine Cervix

Pérez, Carlos A.; Grigsby, Perry W.; Chao, K. A.; Mutch, David G.; Lockett, Mary Ann

doi:10.1016/s0360-3016(98)00067-4

Cited by 216 publications

(106 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7,10,12 In the large LDR series, the 5-year PC and OS rates were approximately 90% and 80%, respectively, for patients with Stage IB disease, 70 -80% and 60 -70%, respectively, for patients with Stage II disease, and 50 -70% and 30 -50%, respectively, for patients with Stage III disease. [22][23][24][25][26] The outcomes achieved in the current series therefore were comparable to those of the large LDR series. The strong correlation between tumor size and treatment outcome is well documented.…”

Section: Discussionsupporting

confidence: 67%

“…When adjusted by stage and tumor size, our results again were comparable to those of the large LDR series. [22][23][24][25][26] Petereit and Pearcey 13 have pointed out that the Point A doses in the current series were less than tumoricidal. However, the sharp dose gradient of ICBT should be taken into account when evaluating the dose response in cervical carcinoma.…”

Section: Discussionmentioning

confidence: 55%

“…The strong correlation between tumor size and treatment outcome is well documented. 5,[22][23][24][25][26] The variation of treatment results among the different reports may be due to the wide range of tumor sizes, even for patients with the same stage of disease. The number of bulky tumors in our patient population was relatively small compared with the number of tumors in the American and European series, 22,23 and this might account for the more favorable outcome.…”

Section: Discussionmentioning

confidence: 99%

“…27,28 In the conventional LDR treatment, the overall treatment time is usually 7-9 weeks. [22][23][24][25][26] In some HDR series, the overall treatment time was Ͼ 8 weeks, because 4 -5 fractions of HDR-ICBT were performed only after delivering 40 -45 Gy of EBRT. 5,8 In contrast, most of the patients in the current study were treated for a period within 6 weeks.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Long‐term results of high‐dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix

Nakano

Kato

Ohno³

et al. 2004

Cancer

146

100

View full text Add to dashboard Cite

BACKGROUNDThe authors performed a long‐term follow‐up study to evaluate the efficacy and late toxicity of high‐dose rate intracavitary brachytherapy (HDR‐ICBT) for cervical carcinoma.METHODSFrom 1968 to 1986, 1148 patients with Stage IB to IVB squamous cell carcinoma of the cervix (staging was performed according to the International Federation of Gynecology and Obstetrics) were treated with a combination of external beam radiotherapy (EBRT) and HDR‐ICBT. For patients with early‐stage disease, 20 gray (Gy) of EBRT was delivered to the whole pelvis, followed by 24 Gy/4 fractions of HDR‐ICBT and 30 Gy of central‐shielding EBRT. For patients with advanced‐stage disease, 20–40 Gy of whole pelvic EBRT was administered, followed by 24 Gy/4 fractions of ICBT and 30–10 Gy of central‐shielding EBRT. The overall treatment time was approximately 6 weeks. Among survivors, the follow‐up rate was 98% and the median follow‐up duration was 22 years.RESULTSThe 10‐year pelvic tumor control rates were 93% for patients with Stage IB disease, 82% for patients with Stage II disease, and 75% for patients with Stage III disease. The 10‐year overall and cause‐specific survival rates were 74% and 89% for patients with Stage IB disease, 52% and 74% for patients with Stage II disease, and 42% and 59% for patients with Stage III disease, respectively. The 10‐year actuarial rates of major complications were 4.4% in the rectosigmoid colon, 0.9% in the bladder, and 3.3% in the small intestines.CONCLUSIONSThe results of the current study suggest that the combination of EBRT and HDR‐ICBT according to the authors' protocol provided outcomes that were comparable to those of the conventional low‐dose rate brachytherapy with acceptable rates of late complications in the treatment of cervical carcinoma. Cancer 2005. © 2004 American Cancer Society.

show abstract

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Long‐term results of high‐dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix

Nakano

Kato

Ohno³

et al. 2004

Cancer

146

100

View full text Add to dashboard Cite

show abstract

“…When assessing molecular factors important for response of tumours to RT it is important to consider the impact of FIGO-stage and tumour size (Eifel et al, 1994;Perez et al, 1998). We previously showed that small tumours more often reach complete remission following brachytherapy as compared with large tumours (Beskow et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Expression of DNA damage response proteins and complete remission after radiotherapy of stage IB–IIA of cervical cancer

et al. 2006

View full text Add to dashboard Cite

The primary aim of this study was to investigate if the expression of the DNA damage identifying protein DNA-PKcs known to be involved in DNA repair after treatment with ionising radiation can be used as a predictive marker for radiotherapy (RT) response in cervical cancer. Formalin-fixed primary tumour biopsies from 109 patients with cervical cancer, FIGO-stage IB -IIA, treated with preoperative brachytherapy followed by radical surgery were analysed by immunohistochemistry. In addition, correlation studies between early pathological tumour response to radiation and expression of Ku86, Ku70, Mdm-2, p53 and p21 in primary tumours were also performed. We found that tumour-transformed tissue shows positive immunostaining of DNA-PKcs, Ku86 and Ku70, while non-neoplastic squamous epithelium and tumour-free cervix glands show negative immunoreactivity. Expression of DNA-PKcs positively correlated with both Ku86 and Ku70, and a statistically significant correlation between the Ku subunits was also found. After RT, 85 patients demonstrated pathologic complete remission (pCR), whereas 24 patients had residual tumour in the surgical specimen (non-pCR). The main finding of our study is that there was no correlation between the outcome of RT and the expression of DNA-PK subunits. Positive p53 tumours were significantly more common among non-pCR cases than in patients with pCR (P ¼ 0.031). Expression of p21 and Mdm-2 did not correlate with the outcome of RT.

show abstract

Uterine Cervix Cancer

Pitson

Fyles

2014

TNM Online

View full text Add to dashboard Cite

Carcinoma of the cervix accounts for approximately 20% of all gynecologic cancers and 2% of all malignancies in women. Numerous prognostic factors have been studied in patients with cervical carcinoma, using both univariate and multivariate analysis. Differences in endpoints of analysis, whether survival (disease‐free or overall), relapse‐free rate, or local control rate, make comparison of such studies difficult. The failure to perform a multivariate analysis, or the use of different covariates in multivariate analyses, can further complicate comparisons between studies. Not all factors are relevant to all patients; for example, depth of tumor invasion and presence of vascular‐space invasion can only be reliably determined in patients treated with surgery, whereas hemoglobin level is important in patients treated with radiation. This review concentrates largely on those factors identified using multivariate techniques, such as log rank or Cox regression analysis, in order to account for interactions between various factors. Where available, estimates such as hazard ratios will be included in order to indicate the strengths of the individual variables.

show abstract

Tumor Size, Irradiation Dose, and Long-Term Outcome of Carcinoma of Uterine Cervix

Cited by 216 publications

References 24 publications

Long‐term results of high‐dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix

Long‐term results of high‐dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix

Expression of DNA damage response proteins and complete remission after radiotherapy of stage IB–IIA of cervical cancer

Uterine Cervix Cancer

Contact Info

Product

Resources

About