1.Shall we settle for low-level evidence?.
Journal of Gynecologic Oncology 2014;25(3):162-163
No abstract available.
Brachytherapy/*methods
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Female
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Humans
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Radiotherapy, Conformal/*methods
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Ultrasonography, Interventional/*methods
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Uterine Cervical Neoplasms/*radiography
2.We should not settle for low-level evidence but should always use the best available evidence.
Kailash NARAYAN ; Linda MILESHKIN ; Sylvia VAN DYK ; David BERNSHAW ; Pearly KHAW ; Srinivas KONDALSAMY CHENNAKESAVAN
Journal of Gynecologic Oncology 2014;25(4):349-351
No abstract available.
Brachytherapy/*methods
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Female
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Humans
;
Radiotherapy, Conformal/*methods
;
Ultrasonography, Interventional/*methods
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Uterine Cervical Neoplasms/*radiography
3.Characteristics of Tuberculosis Detected during Chemotherapy for a Solid Tumor.
Deog Kyeom KIM ; Sei Won LEE ; Young Ae KANG ; Young Soon YOON ; Chul Gyoo YOO ; Young Whan KIM ; Sung Koo HAN ; Young Soo SHIM ; Jae Joon YIM
Tuberculosis and Respiratory Diseases 2005;58(3):285-290
BACKGROUND: Some malignancies including lymphoma, head and neck cancer, and lung cancer are believed to be associated with the reactivation of tuberculosis (TB) because cyclic anti-cancer chemotherapy can induce the leukopenia or immunological deterioration. This report describes the clinical characteristics and treatment response of TB that developed during cyclic anti-cancer chemotherapy in patients with a solid tumor. MATERIALS AND METHODS: From January 1 2000 to July 31 2004, patients with TB diagnosed microbiologically, pa?thologically, or clinically during anti-cancer chemotherapy in a tertiary hospital were enrolled, and their medical records were reviewed. Patients with the known risk factors for the reactivation of TB were excluded. RESULTS: Twenty-two patients were enrolled and their mean age was 56.5 years (range 21-78). The male to female ratio was 3.4:1 and pulmonary TB was the main variant (20 patients, 90.9%). Gastric cancer (10 patients, 45.4%) and lymphoma (4 patients, 18.2%) were the leading underlying malignancies. The other malignancies included lung cancer, head and neck cancer, breast cancer, cervix cancer, and ovary cancer. Fifteen patients (68.2%) had a healed scar on a simple chest radiograph suggesting a previous TB infection. Among these patients, new TB lesions involved the same lobe or the ipsilateral pleura in 13 patients (87.6%). An isoniazid and rifampicin based regimen were started in all the subjects except for one patient with a hepatic dysfunction. The mean duration of medication was 9.9 +/- 2.4 months and no adverse events resulting in a regimen change were observed. With the exception of 5 patients who died of the progression of the underlying malignancy, 70.6% (12/17) completed the anti-TB treatment. CONCLUSION: The clinical characteristics and response to anti-TB treatment for TB that developed during anti- cancer chemotherapy for a solid tumor were not different from those of patients who developed TB in the general population.
Breast Neoplasms
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Cicatrix
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Drug Therapy*
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Female
;
Head and Neck Neoplasms
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Humans
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Isoniazid
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Leukopenia
;
Lung Neoplasms
;
Lymphoma
;
Male
;
Medical Records
;
Ovarian Neoplasms
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Pleura
;
Radiography, Thoracic
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Rifampin
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Risk Factors
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Stomach Neoplasms
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Tertiary Care Centers
;
Tuberculosis*
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Uterine Cervical Neoplasms
4.Women's Cancer Screening According to Body Mass Index in a Cohort of Rural Korean Women.
Bo Hwan KIM ; Sang Baek KOH ; Hea Kung HUR ; Jong Ku PARK ; So Mi PARK
Journal of Korean Academy of Nursing 2009;39(5):641-650
PURPOSE: This study was done to examine the difference in cancer screening with mammography and Papanicolaou smear according to Body Mass Index (BMI). METHODS: The participants in this study were 5,912 women ages 40 to 69 yr, selected from the Korean Genomic Regional Cohort in Kangwon province. Mammography and Papanicolaou smear were assessed by questionnaire and body weight (kg) and height (m) measured to calculate BMI. RESULTS: The distribution of BMI was as follows: low weight (1.5%), normal weight (31.1%), over weight (24.6%), mildly obese (36.4%) and severely obese (6.3%). After adjusting for age, education and monthly income, compared with normal weight women, overweight women (odds ratio [OR]=1.283, 95% confidence interval [CI]=1.089-1.513) and mildly obese women (OR=1.214, 95% CI=1.048-1.406) were less likely to have had mammography. In contrast to mammography, cancer screening with Papanicolaou smear was not significantly different by BMI. CONCLUSION: Obese women in rural areas are less likely to screen for breast cancer by using mammography than non obese women. To ensure regular screening for breast cancer, health care providers need to give scrupulous care to obese women and remove barriers originated from obesity. Also, educational and clinical implications are considered to increase the Papanicolaou smear rate.
Adult
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Aged
;
*Body Mass Index
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Breast Neoplasms/prevention & control/*radiography
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Cohort Studies
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Demography
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Female
;
Humans
;
*Mammography
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Middle Aged
;
Obesity/psychology
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Republic of Korea
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Rural Population
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Uterine Cervical Neoplasms/*pathology/prevention & control
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*Vaginal Smears
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Women's Health
5.Müllerian duct anomalies and their effect on the radiotherapeutic management of cervical cancer.
Madhup RASTOGI ; Swaroop REVANNASIDDAIAH ; Pragyat THAKUR ; Priyanka THAKUR ; Manish GUPTA ; Manoj K GUPTA ; Rajeev K SEAM
Chinese Journal of Cancer 2013;32(8):434-440
Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread. However, in patients with distorted anatomy, several practical issues arise in the delivery of optimal radiotherapy, especially with brachytherapy. Müllerian duct anomalies result in congenital malformations of the female genital tract. Though being very commonly studied for their deleterious effects on fertility and pregnancy, they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer. Here, we discuss the management of cervical cancer among patients with Müllerian duct anomalies and review the very sparse amount of published literature on this topic.
Brachytherapy
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Diagnostic Imaging
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Female
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Genital Diseases, Female
;
diagnosis
;
diagnostic imaging
;
pathology
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Humans
;
Magnetic Resonance Imaging
;
Mullerian Ducts
;
abnormalities
;
diagnostic imaging
;
pathology
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Radiography
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Radiosurgery
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Radiotherapy
;
methods
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Uterine Cervical Neoplasms
;
radiotherapy
;
surgery
6.Effect of xunxi no.1 intervention and radiotherapy on Ia-IIb stage cervical cancer with high-risk human papilloma virus infection.
Pei-ying ZHANG ; Ling LIU ; Xu-bo WANG
Chinese Journal of Integrated Traditional and Western Medicine 2011;31(8):1066-1069
OBJECTIVETo explore the clinical value of Chinese medical intervention and treatment of high-risk human papilloma virus (HR-HPV) infection in patients of cervical cancer (CC) during radiotherapy (RT).
METHODSEighty CC patients of the Ia-IIb stage receiving primary RT were assigned to two groups. RT and local intervention by Xunxi No. 1 was given to patients in the test group for 20 days, while patients in the control group were treated with RT alone. Expression of high-risk HPV (HR-HPV, HPV16/18 infection) was detected by in-situ hybridization (ISH) before and after treatment. The 5-year disease free survival rate and pelvic lymph node metastasis rate (with the lymph node diameter >0.9 cm shown by CT) in patients were observed.
RESULTSAfter treatment, the HR-HPV positive rate was lowered from 67.5% (27/40) to 37.5% (15/40) in the test group (P<0.05), while it was lowered from 72.5% (29/40) to 65.0% (26/40) in the control group (P>0.05). By follow-ups, the 3-year disease free survival rate in the test group was better than that in the control group (33/40 vs 27/40), showing insignificant difference between the two groups (P>0.05). Significant difference was shown in the 5-year disease free survival rate and the pelvic lymph node metastasis rate (65.0% vs 42.5%, 7.5% vs 25.0%) between the two groups (both P<0.05).
CONCLUSIONSIn early RT of CC, combined application of Xunxi No. 1 could obviously lower the HPV positive rate. The 5-year disease free survival rate was superior to that in the control group, with lower pelvic lymph node metastasis rate. Xunxi No. 1 had better clinical value in clinical application.
Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; diagnostic imaging ; therapy ; Phytotherapy ; Radiography ; Survival Rate ; Uterine Cervical Neoplasms ; diagnostic imaging ; therapy ; virology ; Young Adult
7.Ultrasound guided conformal brachytherapy of cervix cancer: survival, patterns of failure, and late complications.
Kailash NARAYAN ; Sylvia VAN DYK ; David BERNSHAW ; Pearly KHAW ; Linda MILESHKIN ; Srinivas KONDALSAMY-CHENNAKESAVAN
Journal of Gynecologic Oncology 2014;25(3):206-213
OBJECTIVE: The aim of this study was to report on the long-term results of transabdominal ultrasound guided conformal brachytherapy in patients with cervical cancer with respect to patterns of failures, treatment related toxicities and survival. METHODS: Three hundred and nine patients with cervical cancer who presented to Institute between January 1999 and December 2008 were staged with magnetic resonance imaging and positron emission tomography and treated with external beam radiotherapy and high dose rate conformal image guided brachytherapy with curative intent. Follow-up data relating to sites of failure and toxicity was recorded prospectively. RESULTS: Two hundred and ninety-two patients were available for analyses. The median (interquantile range) follow-up time was 4.1 years (range, 2.4 to 6.1 years). Five-year failure free survival and overall survival (OS) were 66% and 65%, respectively. Primary, pelvic, para-aortic, and distant failure were observed in 12.5%, 16.4%, 22%, and 23% of patients, respectively. In multivariate analysis, tumor volume and nodal disease related to survival, whereas local disease control and point A dose did not. CONCLUSION: Ultrasound guided conformal brachytherapy of cervix cancer has led to optimal local control and OS. The Melbourne protocol compares favorably to the more technically elaborate and expensive GEC-ESTRO recommendations. The Melbourne protocol's technical simplicity with real-time imaging and treatment planning makes this a method of choice for treating patients with cervical cancer.
Adenocarcinoma/pathology/radiography/secondary/ultrasonography
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Adult
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Aged
;
Brachytherapy/adverse effects/*methods
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Carcinoma, Squamous Cell/pathology/radiography/secondary/ultrasonography
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Female
;
Follow-Up Studies
;
Humans
;
Kaplan-Meier Estimate
;
Lymphatic Metastasis
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Middle Aged
;
Neoplasm Staging
;
Prognosis
;
Prospective Studies
;
Radiation Dosage
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Radiotherapy, Conformal/adverse effects/*methods
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Treatment Failure
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Ultrasonography, Interventional/*methods
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Uterine Cervical Neoplasms/pathology/*radiography/ultrasonography