Year 2013,
Volume: 16 Issue: 3, 0 - 0, 01.07.2013
Abstract
Erken evre serviks kanseri nedeniyle opere olan ve parametrium
tutulumu, lenf nodu metastazı ya da cerrahi sınır pozitişiği nedeniyle
“yüksek riskli” kabul edilen hastalarda adjuvan kemoradyoterapinin
hem hastalıksız hem de genel sağkalıma katkısı olduğu bilinmektedir.
Ancak “orta riskli” kabul edilen olgularda adjuvan radyoterapi
ile rekürrenssiz sağkalım avantajı sağlanmış olsa da genel sağkalım
avantajı gösterilememiştir ve toksisitenin önemli bir sorun olduğu düşünülmektedir.
Bu yazıda primer tedavi olarak radikal cerrahinin tercih
edildiği hastalarda “orta risk” grubunun özellikleri ve bu grupta
adjuvan radyoterapinin endikasyonları tartışılacaktır
Keywords
References
- 1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D: Global cancer statistics. CA Cancer J Clin; 61(2): 69- 90.
- 2. Walboomers JM, Jacobs MV, Manos MM, et al.: Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189(1): 12-9.
- 3. Quinn M, Babb P, Jones J, Allen E: Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics. BMJ 1999; 318(7188): 904-8.
- 4. Landoni F, Maneo A, Colombo A, et al.: Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet 1997; 350(9077): 535-40.
- 5. Monk BJ, Wang J, Im S, et al.: Rethinking the use of radiation and chemotherapy after radical hysterectomy: a clinical-pathologic analysis of a Gynecologic Oncology Group/Southwest Oncology Group/Radiation Therapy Oncology Group trial. Gynecol Oncol 2005; 96(3): 721-8.
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- 7. Delgado G, Bundy B, Zaino R, Sevin BU, Creasman WT, Major F: Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol 1990; 38(3): 352-7. 8. Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ: A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study. Gynecol Oncol 1999; 73(2): 177-83.
- 9. Rotman M, Sedlis A, Piedmonte MR, et al.: A phase III randomized trial of postoperative pelvic irradiation in Stage IB cervical carcinoma with poor prognostic features: follow-up of a gynecologic oncology group study. Int J Radiat Oncol Biol Phys 2006; 65(1): 169-76.
- 10. Smith HO, Tiffany MF, Qualls CR, Key CR: The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States—a 24-year population-based study. Gynecol Oncol 2000; 78(2): 97-105.
- 11. Gien LT, Beauchemin MC, Thomas G: Adenocarcinoma: a unique cervical cancer. Gynecol Oncol; 116(1): 140-6.
- 12. Rogers L, Siu SS, Luesley D, Bryant A, Dickinson HO: Radiotherapy and chemoradiation after surgery for early cervical cancer. Cochrane Database Syst Rev; 5: CD007583.
- 13. Bilek K, Ebeling K, Leitsmann H, Seidel G: Radical pelvic surgery versus radical surgery plus radiotherapy for stage Ib carcinoma of the cervix uteri. Preliminary results of a prospective randomized clinical study. Arch Geschwulstforsch 1982; 52(3): 223-9.
- 14. Zivanovic O, Alektiar KM, Sonoda Y, et al.: Treatment patterns of FIGO Stage IB2 cervical cancer: a single-institution experience of radical hysterectomy with individualized postoperative therapy and definitive radiation therapy. Gynecol Oncol 2008; 111(2): 265-70.
- 15. Ryu SY, Park SI, Nam BH, et al.: Is adjuvant chemoradiotherapy overtreatment in cervical cancer patients with intermediate risk factors? Int J Radiat Oncol Biol Phys; 79(3): 794-9.
- 16. Song S, Song C, Kim HJ, et al.: 20 year experience of postoperative radiotherapy in IB-IIA cervical cancer patients with intermediate risk factors: impact of treatment period and concurrent chemotherapy. Gynecol Oncol; 124(1): 63-7.
- 17. Gaffney DK, Du Bois A, Narayan K, et al.: Practice patterns of radiotherapy in cervical cancer among member groups of the Gynecologic Cancer Intergroup (GCIG). Int J Radiat Oncol Biol Phys 2007; 68(2): 485-90.
- 18. Wolfson AH, Varia MA, Moore D, et al.: ACR Appropriateness Criteria(R) role of adjuvant therapy in the management of early stage cervical cancer. Gynecol Oncol; 125(1): 256-62.
- 19. Cervical cancer. NCCN Guidelines Version I. 2012., www.nccn.org
Year 2013,
Volume: 16 Issue: 3, 0 - 0, 01.07.2013
Abstract
Adjuvant chemoradiotherapy improves progression-free (PFS)
and overall survival (OS) in “high risk” patients with early stage cervical
cancer who are operated and have lymph node metastases, parametrial
involvement or positive surgical margins. However, adjuvant
radiotherapy was shown to improve PFS but not OS in patients with
“intermediate risk” disease and toxicity of radiotherapy is of concern
in this subgroup. We herein reviewed the characteristics of surgically
treated early stage intermediate risk patients and discussed the indications
of radiotherapy in these patients
References
- 1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D: Global cancer statistics. CA Cancer J Clin; 61(2): 69- 90.
- 2. Walboomers JM, Jacobs MV, Manos MM, et al.: Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189(1): 12-9.
- 3. Quinn M, Babb P, Jones J, Allen E: Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics. BMJ 1999; 318(7188): 904-8.
- 4. Landoni F, Maneo A, Colombo A, et al.: Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet 1997; 350(9077): 535-40.
- 5. Monk BJ, Wang J, Im S, et al.: Rethinking the use of radiation and chemotherapy after radical hysterectomy: a clinical-pathologic analysis of a Gynecologic Oncology Group/Southwest Oncology Group/Radiation Therapy Oncology Group trial. Gynecol Oncol 2005; 96(3): 721-8.
- 6. Peters WA, 3rd, Liu PY, Barrett RJ, 2nd, et al.: Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol 2000; 18(8): 1606-13.
- 7. Delgado G, Bundy B, Zaino R, Sevin BU, Creasman WT, Major F: Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol 1990; 38(3): 352-7. 8. Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ: A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study. Gynecol Oncol 1999; 73(2): 177-83.
- 9. Rotman M, Sedlis A, Piedmonte MR, et al.: A phase III randomized trial of postoperative pelvic irradiation in Stage IB cervical carcinoma with poor prognostic features: follow-up of a gynecologic oncology group study. Int J Radiat Oncol Biol Phys 2006; 65(1): 169-76.
- 10. Smith HO, Tiffany MF, Qualls CR, Key CR: The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States—a 24-year population-based study. Gynecol Oncol 2000; 78(2): 97-105.
- 11. Gien LT, Beauchemin MC, Thomas G: Adenocarcinoma: a unique cervical cancer. Gynecol Oncol; 116(1): 140-6.
- 12. Rogers L, Siu SS, Luesley D, Bryant A, Dickinson HO: Radiotherapy and chemoradiation after surgery for early cervical cancer. Cochrane Database Syst Rev; 5: CD007583.
- 13. Bilek K, Ebeling K, Leitsmann H, Seidel G: Radical pelvic surgery versus radical surgery plus radiotherapy for stage Ib carcinoma of the cervix uteri. Preliminary results of a prospective randomized clinical study. Arch Geschwulstforsch 1982; 52(3): 223-9.
- 14. Zivanovic O, Alektiar KM, Sonoda Y, et al.: Treatment patterns of FIGO Stage IB2 cervical cancer: a single-institution experience of radical hysterectomy with individualized postoperative therapy and definitive radiation therapy. Gynecol Oncol 2008; 111(2): 265-70.
- 15. Ryu SY, Park SI, Nam BH, et al.: Is adjuvant chemoradiotherapy overtreatment in cervical cancer patients with intermediate risk factors? Int J Radiat Oncol Biol Phys; 79(3): 794-9.
- 16. Song S, Song C, Kim HJ, et al.: 20 year experience of postoperative radiotherapy in IB-IIA cervical cancer patients with intermediate risk factors: impact of treatment period and concurrent chemotherapy. Gynecol Oncol; 124(1): 63-7.
- 17. Gaffney DK, Du Bois A, Narayan K, et al.: Practice patterns of radiotherapy in cervical cancer among member groups of the Gynecologic Cancer Intergroup (GCIG). Int J Radiat Oncol Biol Phys 2007; 68(2): 485-90.
- 18. Wolfson AH, Varia MA, Moore D, et al.: ACR Appropriateness Criteria(R) role of adjuvant therapy in the management of early stage cervical cancer. Gynecol Oncol; 125(1): 256-62.
- 19. Cervical cancer. NCCN Guidelines Version I. 2012., www.nccn.org
There are 18 citations in total.
Details
| Other ID | JA56RJ49GD |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | July 1, 2013 |
| Submission Date | July 1, 2013 |
| Published in Issue | Year 2013 Volume: 16 Issue: 3 |