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Journal articles on the topic 'Locally advanced cervical cancer'

Author: Grafiati

Published: 29 March 2025

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1

Manders, Dustin B., Abel Morón, Donald McIntire, David S. Miller, Debra L. Richardson, Siobhan M. Kehoe, Kevin V. Albuquerque, and Jayanthi S. Lea. "Locally Advanced Cervical Cancer." American Journal of Clinical Oncology 41, no. 5 (May 2018): 447–51. http://dx.doi.org/10.1097/coc.0000000000000300.

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2

Rose, Peter G. "Locally advanced cervical cancer." Current Opinion in Obstetrics and Gynecology 13, no. 1 (February 2001): 65–70. http://dx.doi.org/10.1097/00001703-200102000-00010.

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3

Kamrava, Mitchell, and Sushil Beriwal. "Pembrolizumab for locally advanced cervical cancer." Lancet 404, no. 10467 (November 2024): 2049. http://dx.doi.org/10.1016/s0140-6736(24)02228-1.

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4

Schmid, Maximilian P., Primoz Petric, Umesh Mahantshetty, Christian Kirisits, Kari Tanderup, Ina Jürgenliemk-Schulz, Jacob Lindegaard, and Richard Pötter. "Pembrolizumab for locally advanced cervical cancer." Lancet 404, no. 10467 (November 2024): 2050–51. http://dx.doi.org/10.1016/s0140-6736(24)02231-1.

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5

Murakami, Naoya, Noriyuki Okonogi, Yasuhisa Terao, and Naoto Shikama. "Pembrolizumab for locally advanced cervical cancer." Lancet 404, no. 10467 (November 2024): 2049–50. http://dx.doi.org/10.1016/s0140-6736(24)02229-3.

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6

Dong, Binhua, Yong Lu, Yue Wang, Pengming Sun, and Huachun Zou. "Pembrolizumab for locally advanced cervical cancer." Lancet 404, no. 10467 (November 2024): 2050. http://dx.doi.org/10.1016/s0140-6736(24)02230-x.

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7

Rojas-Espaillat, Luis A., and Peter G. Rose. "Management of locally advanced cervical cancer." Current Opinion in Oncology 17, no. 5 (September 2005): 485–92. http://dx.doi.org/10.1097/01.cco.0000174049.14515.8d.

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8

Petsuksiri, Janjira, Atthapon Jaishuen, Pittayapoom Pattaranutaporn, and Yaowalak Chansilpa. "Advanced Imaging Applications for Locally Advanced Cervical Cancer." Asian Pacific Journal of Cancer Prevention 13, no. 5 (May 30, 2012): 1713–18. http://dx.doi.org/10.7314/apjcp.2012.13.5.1713.

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9

Trukhacheva, N. G., I. G. Frolova, L. A. Kolomiets, A. V. Usova, E. G. Grigor’ev, S. A. Velichko, and O. N. Churuksaeva. "Novel approaches to diagnostic imaging of locally advanced cervical cancer." Siberian journal of oncology 18, no. 2 (April 26, 2019): 83–91. http://dx.doi.org/10.21294/1814-4861-2019-18-2-83-91.

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Cervical cancer is the second most common cancer after breast cancer and the third most common cause of cancer-related death followed by breast and lung cancers among women worldwide. advances in diagnostic imaging techniques provide better assessment of regional and distant cervical cancer metastasis. the use of contrast-enhanced ultrasound is a revolutionary imaging modality; it has several advantages over ct: no radiation exposure, nephrotoxicity, obtaining real-time information, relatively low cost and ease of use. currently, the contrast agent sonoVue is widely used in ultrasound imaging of liver, kidneys and pancreas lesions, as well as for closed abdominal injuries, multiple organ failure, breast and prostate cancers, etc. However, the role of contrast-enhanced ultrasound in gynecology is not clearly established. one of the most effective tools for the detection of locally advanced cervical cancer is mRi, which is used mainly to determine the local extent of the tumor. However, the use of functional mRitechniques has not yet been included in the standards. cervical cancer tissue has been found to show significantly lower diffusion-weighted imaging (dWi) values than normal cervical tissue, thus facilitating the detection of tumor and its spread. dWiis also used for differentiating changes after biopsy from residual tumor and for identifying small lymph nodes. the pEt/cttechnique combines the metabolic images of pEtwith anatomical images of ctand is more accurate than high resolution ctalone, especially in determining the involvement of regional lymph nodes and distant organs. 18-Fdg-pEt/cthas been successfully used for accurate staging of the disease (especially late stage), assessment of treatment response, radiotherapy planning, and detection of disease progression. in patients with advanced stages of cervical cancer (iiBiV stage), the 18-Fdg-pEt/ ctfindings can determine the treatment strategy in most cases, primarily due to high sensitivity (75–100 %) and specificity (87–100 %) in the detection of lymph node metastases.

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10

Gennigens, Christine, Marjolein De Cuypere, Johanne Hermesse, Frédéric Kridelka, and Guy Jerusalem. "Optimal treatment in locally advanced cervical cancer." Expert Review of Anticancer Therapy 21, no. 6 (March 11, 2021): 657–71. http://dx.doi.org/10.1080/14737140.2021.1879646.

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11

Iwata, Takashi, Azumi Miyauchi, Yukako Suga, Hiroshi Nishio, Masaru Nakamura, Akiko Ohno, Nobumaru Hirao, et al. "Neoadjuvant chemotherapy for locally advanced cervical cancer." Chinese Journal of Cancer Research 28, no. 2 (2016): 235–40. http://dx.doi.org/10.21147/j.issn.1000-9604.2016.02.13.

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12

杨, 佳俊. "Treatment Status of Locally Advanced Cervical Cancer." Advances in Clinical Medicine 11, no. 11 (2021): 5069–72. http://dx.doi.org/10.12677/acm.2021.1111746.

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13

Bezhanova, E. G., and I. V. Berlev. "LAPAROSCOPIC STAGING IN LOCALLY ADVANCED CERVICAL CANCER." Tumors of female reproductive system 14, no. 1 (April 12, 2018): 71–77. http://dx.doi.org/10.17650/1994-4098-2018-14-1-71-77.

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14

Goodwin, Peter M. "Chemoradiation Better for Locally Advanced Cervical Cancer." Oncology Times 39, no. 19 (October 2017): 30. http://dx.doi.org/10.1097/01.cot.0000526143.40845.e9.

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15

Runowicz, Carolyn D., Harriet O. Smith, and Gary L. Goldberg. "Multimodality therapy in locally advanced cervical cancer." Current Opinion in Obstetrics and Gynecology 5, no. 1 (February 1993): 92–98. http://dx.doi.org/10.1097/00001703-199302000-00016.

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16

Carlson, Robert H. "Locally Advanced Cervical Cancer Responds to Gemcitabine." Oncology Times 31, no. 16 (August 2009): 20. http://dx.doi.org/10.1097/01.cot.0000360403.66910.87.

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17

Naga CH, Pushpa, Lavanya Gurram, Supriya Chopra, and Umesh Mahantshetty. "The management of locally advanced cervical cancer." Current Opinion in Oncology 30, no. 5 (September 2018): 323–29. http://dx.doi.org/10.1097/cco.0000000000000471.

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18

Timotheadou, E., and M. E. Gore. "Neoadjuvant chemotherapy for locally advanced cervical cancer." European Journal of Cancer 39, no. 17 (November 2003): 2419–21. http://dx.doi.org/10.1016/s0959-8049(03)00578-1.

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19

Niël, Charles G. J. H., Peter C. M. Koper, Andries G. Visser, Dick Sipkema, and Peter C. Levendag. "Optimizing brachytherapy for locally advanced cervical cancer." International Journal of Radiation Oncology*Biology*Physics 29, no. 4 (July 1994): 873–77. http://dx.doi.org/10.1016/0360-3016(94)90579-7.

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20

Karimova, F. N. "Chemoradiation therapy for locally advanced cervical cancer." Onkologiya. Zhurnal imeni P.A.Gertsena 4, no. 3 (2015): 16. http://dx.doi.org/10.17116/onkolog20154316-19.

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21

Dueñas-González, Alfonso, Lucely Cetina-Pérez, Luis Fernando Oñate-Ocaña, Lesbia Rivera, Carlos Lopez-Graniel, Aaron González-Enciso, Myrna Candelaria, and Alejandro Mohar. "Multimodal Treatment of Locally Advanced Cervical Cancer." Archives of Medical Research 36, no. 2 (March 2005): 129–35. http://dx.doi.org/10.1016/j.arcmed.2004.12.008.

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22

Sari, Sezin Yuce, Nur Nimet Saliha Akdag, Melis Gultekin, and Ferah Yildiz. "Adjuvant chemotherapy for locally advanced cervical cancer." Lancet Oncology 24, no. 7 (July 2023): e289. http://dx.doi.org/10.1016/s1470-2045(23)00270-x.

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23

Nasioudis, Dimitrios, Erin M. George, and Janos L. Tanyi. "Controversies in the Staging of Patients with Locally Advanced Cervical Cancer." Diagnostics 13, no. 10 (May 16, 2023): 1747. http://dx.doi.org/10.3390/diagnostics13101747.

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Approximately 10–25% of patients with locally advanced cervical cancer harbor metastases to the para-aortic lymph nodes. Staging of patients with locally advanced cervical cancer can be performed with imaging techniques, such as PET-CT; however, false negative rates can be as high as 20%, especially for patients with pelvic lymph node metastases. Surgical staging can identify patients with microscopic lymph nodes metastases and aid in accurate treatment planning with the administration of extended-field radiation therapy. Data from retrospective studies investigating the impact of para-aortic lymphadenectomy on the oncological outcomes of patients with locally advanced cervical cancer are mixed, while data from randomized controlled trials do not demonstrate a progression-free survival benefit. In the present review, we explore controversies in the staging of patients with locally advanced cervical cancer and summarize the available literature.

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24

Dueñas-González, Alfonso, Lucely Cetina, Jaime Coronel, and Déborah Martínez-Baños. "Pharmacotherapy Options for Locally Advanced and Advanced Cervical Cancer." Drugs 70, no. 4 (March 2010): 403–32. http://dx.doi.org/10.2165/11534370-000000000-00000.

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25

Sakuragi, Noriaki, Masanori Kaneuchi, Tatsuya Kato, Chisa Shimada, Yukiharu Todo, Kei Ihira, Ayako Nozaki, et al. "Tailored radical hysterectomy for locally advanced cervical cancer." International Journal of Gynecologic Cancer 30, no. 8 (June 9, 2020): 1136–42. http://dx.doi.org/10.1136/ijgc-2020-001387.

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ObjectiveThe survival and prognostic factors for locally advanced cervical cancer treated with nerve-sparing Okabayashi–Kobayashi radical hysterectomy have not been elucidated. We aimed to evaluate the oncological outcomes of those patients after radical hysterectomy with adjuvant chemotherapy.MethodsThis retrospective cohort study was conducted from January 2002 to December 2011. Treatment was conducted at a single tertiary center in northern Japan. We used the Okabayashi–Kobayashi radical hysterectomy with lymphadenectomy. We applied unilateral nerve preservation for stage IIA/IIB cancer if there was a one-sided extension of the disease outside the cervix. Indication for adjuvant therapy was based on Sedlis criteria. High-risk was defined as evidence of lymph node metastasis, pathological parametrial invasion, and a positive/close surgical margin. The choice of adjuvant therapy was chemotherapy which consisted of paclitaxel and cisplatin.ResultsThe study included 76 early-stage IB1 (≤4 cm) and IIA1 cervical cancer and 45 locally advanced stage IB2 (>4 cm), IIA2, and IIB disease treated consecutively. The median follow-up was 106 (range: 6-203) months. There were 18 (15%) patients with recurrence, with five of 76 in the early-stage (7%) and 13 of 45 in the locally advanced disease (29%) (P<0.001). For locally advanced cervical cancer, pT classification (P<0.001), lymph node metastasis (P=0.007), and histology (P=0.05) were associated with locoregional recurrence. The five-year locoregional recurrence rate in the locally advanced disease was 20% and 5% in the early-stage disease (P=0.01). The five-year disease-free survival in the locally advanced cervical cancer was 71% and 93% in the early-stage disease (P<0.001). The overall survival in locally advanced disease depended on the adeno-type histology and lymph node metastasis.ConclusionThe tailored use of nerve-sparing Okabayashi–Kobayashi radical hysterectomy with adjuvant chemotherapy based on tumor histology and lymph node metastasis may be a possible option as a treatment of locally advanced cervical cancer in selected patients.

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26

Massobrio, Roberta, Lavinia Bianco, Beatrice Campigotto, Daniela Attianese, Elisa Maisto, Maria Pascotto, Maria Grazia Ruo Redda, and Annamaria Ferrero. "New Frontiers in Locally Advanced Cervical Cancer Treatment." Journal of Clinical Medicine 13, no. 15 (July 30, 2024): 4458. http://dx.doi.org/10.3390/jcm13154458.

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Despite the introduction of targeted vaccines and screening protocols, locally advanced cervical cancer represents a median proportion of 37% among all cervical carcinomas. Compared to early stages, it presents significantly lower cure rates, with a 5-year disease-free survival rate of 68% and a 5-year overall survival rate of 74%. According to current guidelines, definitive radiotherapy with concomitant chemotherapy represents the gold standard for locally advanced cervical cancer treatment. However, a significant number of patients relapse and die from metastatic disease. The aim of this narrative review is to examine the recent advancements in treating locally advanced cervical cancer, exploring new frontiers in therapeutic approaches. The PubMed database and clinical trial registries were searched to identify relevant articles published on locally advanced cervical cancer treatment up to March 2024, mainly focusing on papers published in the last decade. Abstracts presented at major international congresses that bring relevant evidence were included. Progress achieved in refining radiotherapy techniques, recent evidence regarding neoadjuvant treatment preceding surgery or concurrent chemoradiotherapy, and key findings concerning adjuvant treatment are thoroughly explored. Furthermore, a comprehensive review of prominent phase II and phase III trials examining the integration of immune checkpoint inhibitors is conducted, analyzing the various contexts in which they are applied. In light of the new evidence that has emerged in recent years and is discussed in this article, the appropriate selection of the most suitable therapeutic approach for each patient remains a complex but crucial issue.

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27

Monk, Bradley J., Krishnansu S. Tewari, and Wui-Jin Koh. "Multimodality Therapy for Locally Advanced Cervical Carcinoma: State of the Art and Future Directions." Journal of Clinical Oncology 25, no. 20 (July 10, 2007): 2952–65. http://dx.doi.org/10.1200/jco.2007.10.8324.

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Globally, cervical cancer is the second most common cause of cancer-related mortality among women causing approximately 234,000 deaths annually among developing countries and killing 40,000 in developed nations. Most of these deaths occur in women with bulky or locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stages IIB through IVA, when lesions are not amenable to high cure rates with surgery or radiation (RT). The standard prescription for RT used to treat locally advanced cervical cancer has been dictated by common practice and patterns of care studies. In contrast, the addition of concomitant chemotherapy to RT has been studied in a number of randomized prospective trials, which are discussed in detail. When added to RT, cisplatin reduces the relative risk of death from cervical carcinoma by approximately 50% by decreasing local/pelvic failure and distant metastases. In 1999, weekly intravenous cisplatin at 40 mg/m2 for 6 weeks in combination with RT was established as a new standard for the treatment of locally advanced cervical carcinoma. More recently, this recommendation has been expanded to include women with FIGO stage IB2 lesions as well as those with bulky stage IIA cancers. This monograph reviews the state of the art in treating locally advanced cervical cancer with combined chemotherapy and RT and discusses clinical and pathologic prognostic factors that impact cure. Quality of life during and after multimodality therapy is considered as well as ongoing clinical trials and future directions.

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28

Vora, Chakor, and Sudeep Gupta. "Targeted therapy in cervical cancer." ESMO Open 3, Suppl 1 (February 2019): e000462. http://dx.doi.org/10.1136/esmoopen-2018-000462.

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Cervical cancer continues to be a common cancer in women worldwide, especially in less developed regions where advanced stage presentations are common. Addition of bevacizumab to cytotoxic chemotherapy has been the only notable recent advance in the treatment of recurrent and metastatic cervical cancer. Outcomes in patients with locally advanced disease have also plateaued after meaningful gains were achieved with concomitant chemoradiation treatment. Recently, progress has been made in understanding the molecular aberrations in cervical cancer and new therapeutic modalities are emerging, including immune checkpoint inhibitors, therapeutic vaccines, antibody-drug conjugates, and others. In this review we will discuss the data and potential utility of these approaches.

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29

Loizzi, V., G. Cormio, G. Loverro, L. Selvaggi, P. J. Disaia, and F. Cappuccini. "Chemoradiation: A new approach for the treatment of cervical cancer." International Journal of Gynecologic Cancer 13, no. 5 (2003): 580–86. http://dx.doi.org/10.1136/ijgc-00009577-200309000-00002.

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Despite advances in screening, cervical cancer remains a major health problem worldwide. In an effort to improve loco-regional control, both neoadjuvant and chemoradiation have been trialed. Recently, five randomized clinical trials performed by the Gynecologic Oncology Group, the Radiation Therapy Oncology Group and the Southwest Oncology Group have demonstrated a significant advantage both in progression-free and overall survival when cisplatin-based chemotherapy was administered during radiation for advanced stages of cervical cancer. Based on the results of these trials, the US National Cancer Institute released a Clinical Announcement supporting the concurrent use of cisplatin-based chemotherapy with radiation therapy for high-risk early stage and locally advanced stage cervical cancer. Subsequently, an additional prospective randomized trial performed by the National Cancer Institute of Canada was not able to show benefit with the use of chemoradiation compared with radiation alone for patients with locally advanced stage cervical cancer. This article will analyze these six clinical trials in order to determine the role of chemoradiation in the management of patients with cervical cancer. Furthermore, as anemia is one of the most powerful prognostic factors in patients with cervical cancer, we propose to evaluate the relationship between a decreased level of hemoglobin and treatment outcome.

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30

Кравец, О., O. Kravets, А. Дубинина, A. Dubinina, Е. Тарачкова, E. Tarachkova, О. Козлов, O. Kozlov, Е. Романова, and E. Romanova. "Brachytherapy for Locally Advanced Cervix Cancer (Methodological Aspects)." Medical Radiology and radiation safety 64, no. 5 (October 21, 2019): 76–80. http://dx.doi.org/10.12737/1024-6177-2019-64-5-76-80.

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Purpose: To increase local control of cervical tumors by developing and introducing into practice the optimization of dose distribution in the primary tumor during concomitant chemoradiation (CRT) and image-guided adaptive brachytherapy (IGABT) i.e. summing up the maximum dose to the tumor volume of HR-CTV> 85 Gy in the shortest possible period of time by the optimal fractionation regime, without increasing the tolerable doses to the organs of risk (bladder, rectum, sigmoid). Material and methods: Data of the study was the of clinical observations of patients with locally advanced cervical cancer proven stage IIb–IIIb according to FIGO, treated with curative radiation therapy. After pelvic +/- para-aortic external-beam radiation therapy (2 Gy × 50 Gy with Cisplatin 40 mg/m2 weekly), they received high-dose rate intracavitary brachytherapy or in combination with interstitial component following GEC-ESTRO recommendations. Results: We managed to achieve maximum dose to the tumor volume of HR-CTV> 85 Gy without increasing the load on the risk organs. The Clinical Contouring at the time of primary diagnosis of cervical cancer and before brachytherapy session based on clinical and diagnostic data using MRI helps to optimize the brachytherapy process, develop patient management tactics and a clear sequence of actions in a complex program of brachytherapy. Conclusion: The presented clinical cases indicate the prospects of using an individual approach in planning the brachytherapy of patients with locally advanced cervical cancer.

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31

Ovodenko, Dmitry L., Grigory N. Khabas, Anna S. Makarova, Mariya S. Pirogova, Alexandr A. Seregin, Yulia S. Golitsyna, and Lev A. Ashrafyan. "Modern ultrasound diagnostics for locally advanced cervical cancer." Modern Oncology 21, no. 2 (2019): 40–45. http://dx.doi.org/10.26442/18151434.2019.2.190331.

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32

Benedetti-Panici, Maneschi, Cutillo, Congiu, Franchi, Amoroso, S. Greggi, and Mancuso. "Laparoscopic abdominal staging in locally advanced cervical cancer." International Journal of Gynecological Cancer 9, no. 3 (May 1999): 194–97. http://dx.doi.org/10.1046/j.1525-1438.1999.99017.x.

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33

Maksimov, Maksimov S. Ya, Khadzhimba A. S. Khadzhimba, Il’in A. A. Il’in, Pletneva A V. Pletneva A, Smirnova M. P. Smirnova, and Balakhnin P. V. Balakhnin. "Super-selective chemoembolization in locally advanced cervical cancer." Akusherstvo i ginekologiia 1-prilojenie_2020 (January 30, 2020): 98–104. http://dx.doi.org/10.18565/aig.2020.1suppl.98-104.

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34

Brunet, Joan, Carmen Alonso, Marta Llanos, Adelaida Lacasta, Josefina Fuentes, Luis A. Mendoza, Josep M. Badia, Enrique Delgado, and Belen Ojeda. "Chemotherapy And Radiotherapy In Locally Advanced Cervical Cancer." Acta Oncologica 34, no. 7 (January 1995): 941–44. http://dx.doi.org/10.3109/02841869509127209.

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35

Barbera, Lisa, and Gillian Thomas. "Management of Early and Locally Advanced Cervical Cancer." Seminars in Oncology 36, no. 2 (April 2009): 155–69. http://dx.doi.org/10.1053/j.seminoncol.2008.12.007.

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36

Patsner, B. "Extraperitoneal Staging Lymphadenectomy for Locally Advanced Cervical Cancer." Obstetrical & Gynecological Survey 50, no. 5 (May 1995): 362–63. http://dx.doi.org/10.1097/00006254-199505000-00018.

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37

Lorusso, Domenica, Karin Yamada, Kan Li, Annamaria Cerrotta, and Gabriella Macchia. "Pembrolizumab for locally advanced cervical cancer – Authors' reply." Lancet 404, no. 10467 (November 2024): 2051–52. http://dx.doi.org/10.1016/s0140-6736(24)02232-3.

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38

Williams, C. "Chemotherapy and radiotherapy for locally advanced cervical cancer." BMJ 318, no. 7192 (May 1, 1999): 1161–62. http://dx.doi.org/10.1136/bmj.318.7192.1161.

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39

Rose, Peter G. "New treatment paradigm for locally advanced cervical cancer?" Nature Reviews Clinical Oncology 8, no. 7 (May 31, 2011): 388–90. http://dx.doi.org/10.1038/nrclinonc.2011.85.

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40

Beswick, Adam, Mark Corkum, and David D’Souza. "Locally advanced cervical cancer in a transgender man." Canadian Medical Association Journal 191, no. 3 (January 20, 2019): E76—E78. http://dx.doi.org/10.1503/cmaj.181047.

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41

Rose, P. G. "Combined-Modality Therapy of Locally Advanced Cervical Cancer." Journal of Clinical Oncology 21, no. 90100 (May 15, 2003): 211s—217. http://dx.doi.org/10.1200/jco.2003.01.222.

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42

Kouhen, Fadila, and Mohammed Sqali Houssaini. "CALLA trial: immunotherapy in locally advanced cervical cancer." Lancet Oncology 25, no. 3 (March 2024): e94. http://dx.doi.org/10.1016/s1470-2045(23)00648-4.

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43

Yang, Xi, Yuanyuan Zhang, Shuangzheng Jia, Jusheng An, and Manni Huang. "CALLA trial: immunotherapy in locally advanced cervical cancer." Lancet Oncology 25, no. 3 (March 2024): e95. http://dx.doi.org/10.1016/s1470-2045(24)00006-8.

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44

Sargin, Fatma Basak, and Mehmet Murat Naki. "Minimally Invasive Approach In Locally Advanced Cervical Cancer." International Journal of Gynecological Cancer 35, no. 2 (February 2025): 100552. https://doi.org/10.1016/j.ijgc.2024.100552.

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45

Dorji, Namkha, Sangay Tshering, and Nishal Chhetri. "Presentation of a Locally Advanced Cervical Cancer with Hydrometrocolpos: A Case Report." Bhutan Health Journal 10, no. 2 (August 11, 2024): 1–5. http://dx.doi.org/10.47811/bhj.170.

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Introduction: Early stages of cervical cancer remain asymptomatic. Its common symptoms are postcoital bleeding, postmenopausal bleeding, heavy menstrual flow and foul smelling blood stained discharge. Presentation of locally advanced cervical cancer with hydrometrocolpos is unusual. Case report: An 83-year-old woman who presented with a large abdomino-pelvic mass was diagnosed as benign bilateral ovarian tumour with left sided hydroureteronephrosis. During laparotomy, the mass was confirmed to be a hydrometrocolpos with left hydroureteronephrosis secondary to a locally advanced cervical cancer (FIGO IIIB). Histology confirmed the diagnosis of invasive squamous cell carcinoma of the cervix. Conclusion: Besides thorough evaluation via symptoms and signs, radiologists have an important role in guiding surgeons to the most probable diagnosis. In an elderly woman with a stenosed vagina and a pelvic mass with hydroureteronephrosis, gynecologists need to be aware of the possibility of locally advanced cervical cancer, and perform relevant preoperative assessments and plan management.

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46

Sundar, Sudha S., Robert J. Gornall, and Sean T. Kehoe. "Advances in the management of cervical cancer." British Menopause Society Journal 11, no. 3 (September 1, 2005): 91–95. http://dx.doi.org/10.1258/136218005775544471.

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This review presents key advances in the management of cervical cancer. Traditionally, cervical cancer is staged clinically and has been treated either by radical hysterectomy or by radiotherapy. Improvements in imaging have led to more accurate therapeutic decision making and treatment planning. The evidence on fertility-preserving surgery for cervical cancer and chemoradiotherapy for locally advanced cancer is summarized here. An improved understanding of the viral aetiology of cervical cancer has led to the development of therapeutic vaccination, with limited success. There is increasing recognition of the psychosexual needs of women who have survived cervical cancer.

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47

Daukantienė, Lina, Konstantinas Povilas Valuckas, Eduardas Aleknavičius, and Teresė Pipirienė-Želvienė. "Chemoradiotherapy in the treatment of locally advanced cervical cancer." Lietuvos chirurgija 12, no. 3 (January 1, 2013): 114–17. http://dx.doi.org/10.15388/lietchirur.2013.3.1842.

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The purpose of this article is overview of currently available knowledge found in literature about the chemoradiation for locally advanced cervical cancer.Cervical cancer is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in females worldwide. Despite the available prevention and early detection strategies, carcinoma of the uterine cervix is still diagnosed as locally advanced disease in a considerable proportion of patients. Standart treatment of locally advanced cervical cancer is cisplatin-based chemoradiation. Unfortunately, results of the treatment are not sufficient and cancer relapses are frequent. New cytostatics regimens either alone or in combination with cisplatin are searching as radiosensitizers with concurrent radiotherapy. Neoadjuvant/induction chemotherapy, adjuvant/consolidation chemotherapy strategies, molecular agents targeting critical pathways are under investigation in clinical trials to improve results of the treatment.The purpose of this article is overview of currently available knowledge found in literature about the chemoradiation for locally advanced cervical cancer.Key words: locally advanced cervical cancer, chemoradiation, adjuvant/consolidation chemotherapy, neoadjuvant/induction chemotherapy.Chemospindulinis vietiškai išplitusio gimdos kaklelio vėžio gydymas Straipsnio tikslas – apžvelgti ir pateikti šiuo metu prieinamoje literatūroje sukauptas žinias apie konservatyvų chemospindulinį vietiškai išplitusio gimdos kaklelio vėžio gydymą.Gimdos kaklelio vėžys yra trečia dažniausiai pasaulyje nustatoma moterų vėžio forma ir ketvirta pagal dažnį moterų mirties nuo vėžio priežastis. Nepaisant profilaktikos priemonių bei patikros programos, nemaža dalis gimdos kaklelio vėžio atvejų nustatoma jau vietiškai išplitusios IIB–IVA stadijos. Šiuo metu vietiškai išplitusio gimdos kaklelio vėžio gydymo standartas – suderintas chemospindulinis gydymas cisplatinos pagrindu. Deja, gydymo rezultatai nėra patenkinami, atkryčio dažnis išlieka didelis. Siekiant geresnių gydymo rezultatų atlikta ir atliekama daug klinikinių tyrimų, spindulinio gydymo metu taikant naujus citostatikus ar jų derinius su cisplatina, tiriama neoadjuvantinės/indukcinės bei adjuvantinės/konsoliduojančios chemoterapijos reikšmė, „taikinių“ terapijos panaudojimo galimybė.Reikšminiai žodžiai: vietiškai išplitęs gimdos kaklelio vėžys, chemospindulinis gydymas, adjuvantinė/konsoliduojanti chemoterapija, neoadjuvantinė/indukcinė chemoterapija.

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Zhou, Yuedan, Sophie Espenel, Samir Achkar, Alexandra Leary, Sebastien Gouy, and Cyrus Chargari. "Combined modality including novel sensitizers in gynecological cancers." International Journal of Gynecologic Cancer 32, no. 3 (March 2022): 389–401. http://dx.doi.org/10.1136/ijgc-2021-002529.

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Standard treatment of locally advanced gynecological cancers relies mainly on platinum-based concurrent chemoradiotherapy followed by brachytherapy. Current chemotherapeutic drugs are only transiently effective and patients with advanced disease often develop resistance and subsequently, distant metastases despite significant initial responses of the primary tumor. In addition, some patients still develop local failure or progression, suggesting that there is still a place for increasing the anti-tumor radiation effect. Several strategies are being developed to increase the probability of curing patients. Vaginal cancer and vulva cancer are rare diseases, which resemble cervical cancer in their histology and pathogenesis. These gynecological cancers are predominantly associated with human papilloma virus infection. Treatment strategies in other unresectable gynecologic cancers are usually derived from evidence in locally advanced cervical cancers. In this review, we discuss mechanisms by which novel therapies could work synergistically with conventional chemoradiotherapy, from pre-clinical and ongoing clinical data. Trimodal, even quadrimodal treatment are currently being tested in clinical trials. Novel combinations derived from a metastatic setting, and being tested in locally advanced tumors, include anti-angiogenic agents, immunotherapy, tumor-infiltrating lymphocytes therapy, adoptive T-cell therapy and apoptosis inducers to enhance chemoradiotherapy efficacy through complementary molecular pathways. In parallel, radiosensitizers, such as nanoparticles and radiosensitizers of hypoxia aim to maximize the effect of radiotherapy locally.

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Miriyala, Raviteja, Umesh Mahantshetty, Amita Maheshwari, and Sudeep Gupta. "Neoadjuvant chemotherapy followed by surgery in cervical cancer: past, present and future." International Journal of Gynecologic Cancer 32, no. 3 (March 2022): 260–65. http://dx.doi.org/10.1136/ijgc-2021-002531.

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BackgroundCisplatin-based concurrent chemoradiation is the standard treatment for locally advanced cervical cancer. In view of the difficulties associated with implementation of standard radiation protocols in low- and middle-income countries and the associated toxicities of chemoradiation, neoadjuvant chemotherapy followed by surgery has been tried as an alternative treatment for locally advanced cervical cancer.MethodsA comprehensive review was undertaken of the existing literature, caveats and potential avenues of neoadjuvant chemotherapy followed by surgery compared with chemoradiation in locally advanced cervical cancer.ResultsRandomized studies conducted in the pre-chemoradiation era comparing neoadjuvant chemotherapy followed by surgery with definitive radiotherapy alone showed favorable outcomes with the chemo-surgical approach. However, contemporary studies evaluating the role of neoadjuvant chemotherapy followed by surgery have failed to establish this approach as the standard. About 25–30% of patients who undergo neoadjuvant chemotherapy remain inoperable and require definitive chemoradiation. A similar proportion of patients would require adjuvant (chemo)radiation after neoadjuvant chemotherapy followed by surgery, resulting in excessive morbidity. Evaluation of time trends across the past few decades reveals that the advancements in delivery of radiation (external beam and brachytherapy) have translated into improvement in outcomes for locally advanced cervical cancer, while a similar trend was not observed for surgery or chemotherapy.ConclusionNeoadjuvant chemotherapy followed by surgery cannot be considered a standard of care in patients with locally advanced cervical cancer. This approach needs further clinical research to generate robust high-quality evidence especially for the sub-sets that might potentially benefit in terms of survival, toxicity and quality of life, against the gold standard treatment of concomitant chemoradiation.

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Ma, T. M., M. M. Harkenrider, C. M. Yashar, A. N. Viswanathan, and J. S. Mayadev. "Understanding the Underutilization of Cervical Brachytherapy for Locally Advanced Cervical Cancer." International Journal of Radiation Oncology*Biology*Physics 102, no. 3 (November 2018): e629-e630. http://dx.doi.org/10.1016/j.ijrobp.2018.07.1719.

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