Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Cervical cancer: Combined modality therapy
Autore:
Grigsby, PW;
Indirizzi:
Washington Univ, Med Ctr, Mallinckrodt Inst Radiol, St Louis, MO 63110 USAWashington Univ St Louis MO USA 63110 Inst Radiol, St Louis, MO 63110 USA
Titolo Testata:
CANCER JOURNAL
, volume: 7, anno: 2001, supplemento:, 1
pagine: S47 - S50
SICI:
1528-9117(200107/08)7:<S47:CCCMT>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
PELVIC RADIATION-THERAPY; BULKY STAGE-IB; CONCURRENT CHEMOTHERAPY; RADICAL SURGERY; HYSTERECTOMY; RADIOTHERAPY; CISPLATIN; CARCINOMA;
Keywords:
cervical cancer; survival; therapy; RTOG; squamous cell carcinoma; pelvic irradiation; brachytherapy; 5-FU; cisplatin;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
8
Recensione:
Indirizzi per estratti:
Indirizzo: Grigsby, PW Washington Univ, Med Ctr, Mallinckrodt Inst Radiol, Box 8224, St Louis, MO63110 USA Washington Univ Box 8224 St Louis MO USA 63110 is, MO63110 USA
Citazione:
P.W. Grigsby, "Cervical cancer: Combined modality therapy", CANCER J, 7, 2001, pp. S47-S50

Abstract

Prospective, randomized studies conducted over the past 10 years have changed the management of patients with advanced cervical cancer. The reviewed studies evaluated the use of surgery, irradiation, and chemotherapy in patients with various stages of cervical carcinoma in the absence and presence of high-risk factors for recurrence. A study by the Radiation Therapy Oncology Group (RTOG) compared pelvic with pelvic plus prophylactic para-aortic irradiation in patients with stages IB (> 4 cm), IIA, and IIB cervical cancer. The 10-year survival advantage was 11% for patients treated with prophylactic para-aortic irradiation. A follow-up study compared pelvic plus prophylactic para-aortic irradiation and brachytherapy with pelvic irradiation,brachytherapy, and chemotherapy with cisplatin and 5-FU in patients with IB-to IVA-stage cervical cancer. Overall and disease-free survivals were significantly improved in patients receiving chemotherapy. In patients with a prevalence of stage IIB and III, the Gynecologic Oncology Group (GOG) demonstrated that treatment with hydroxyurea alone was inferior to cisplatin or cisplatin, 5-FU, and hydroxyurea in patients treated concurrently with pelvic irradiation and brachytherapy, and the GOG adopted irradiation and weekly cisplatin as standard therapy. Further GOG studies suggest that irradiation and weekly cisplatin chemotherapy without hysterectomy is the optimal treatment for patients with stage IB cervical cancer. High-risk factors for recurrence include tumor size, depth of tumor invasion, lymphovascular spaceinvolvement, and lymph node involvement. Prospective, randomized studies conducted by the GOG evaluated the effectiveness of various treatments in patients with high-risk factors. In one study that did not use chemotherapy, the recurrence-free interval was about 10% better for stage IB patients receiving postoperative irradiation after radical hysterectomy and pelvic lymphadenectomy compared with those who received no further therapy. Patients with Stages IB and IIA disease who, following radical hysterectomy and lymphnode dissection, are identified as having positive pelvic lymph nodes and positive parametrial involvement, are at higher risk for recurrence and death than the high-risk group described above. An intergroup study conducted by the GOG, RTOG, and Southwest Oncology Group compared postoperative pelvic irradiation alone with postoperative pelvic irradiation plus concurrent chemotherapy in this group of patients. Overall and progression-free survivals were superior for patients receiving chemotherapy, and their greatest survival occurred in patients who received 3 or 4 chemotherapy cycles compared with 1 or 2 cycles or no chemotherapy. These findings are summarized withrespect to their implications for treatment of patients with advanced cervical cancer.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/02/20 alle ore 12:43:17