Clinical Ovarian and Other Gynecologic Cancer最新文献

英文中文

Small-Cell Carcinoma in Association With a Mature Cystic Teratoma of the Ovary: A Case Report With Literature Review 小细胞癌合并卵巢成熟囊性畸胎瘤1例报告并文献复习

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2013.12.006

Karina E. Hew , Kimberley Studeman , Panayotis Ledakis , Arvind Bakhru , Neil B. Rosenshein

引用次数: 2

Short-Term Morbidity and Clinical Response After a 2-Week Versus 6-Week Interval From Debulking Surgery to Adjuvant Chemotherapy in Epithelial Ovarian Cancer 上皮性卵巢癌从减肿手术到辅助化疗间隔2周和6周后的短期发病率和临床反应

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2013.12.005

Mohamad Nasir Shafiee , Azmaniza Baharuddin , Maiza Tusimin , Nirmala Kampan , Arifuddin Djuanna , Ahmad Zailani Hatta Mohd Dali

Background

The purpose of this study was to determine the effect of time interval between debulking surgery to adjuvant chemotherapy on the short-term morbidity and carcinoma antigen (CA)-125 level.

Patients and Methods

A total of 43 patients with primary debulking surgery for operable stage epithelial ovarian cancer (stage IB to IIIC) from January 2008 to January 2010 were analyzed prospectively. The participants were randomized into 2 groups. The surgical–chemotherapy interval group 2 (SCI2) (n = 22) received adjuvant chemotherapy (carboplatin and paclitaxel) within 2 weeks after primary debulking surgery and the SCI6 (n = 21) group received the same chemotherapy agents 6 weeks after the primary surgery. A computerized randomization technique was used.

Results

Participants in the SCI2 group had a better CA-125 reduction after 6 cycles of chemotherapy (P < .005) compared with the SCI6 group. The incidence of anemia was more significant in the SCI2 group (P < .005) than in the other group. However, there were no significant differences in wound breakdown, neutropenia, thrombocytopenia, and clinical response of chemotherapy between the 2 groups.

Conclusion

Time interval between primary surgery to the commencement of adjuvant chemotherapy had no significant effect on short-term morbidity, but had an improved effect on biochemical (CA-125) response.

本研究的目的是确定减容手术与辅助化疗之间的时间间隔对短期发病率和癌抗原(CA)-125水平的影响。患者和方法对2008年1月至2010年1月43例可手术期上皮性卵巢癌(IB ~ IIIC期)行原发性减体积手术的患者进行前瞻性分析。参与者被随机分为两组。手术-化疗间隔组2 (SCI2) (n = 22)在初次减体积手术后2周内接受辅助化疗(卡铂和紫杉醇)，SCI6 (n = 21)组在初次手术后6周接受相同的化疗药物。采用计算机随机化技术。结果SCI2组患者在化疗6个周期后CA-125降低较好(P <.005)与SCI6组比较。SCI2组的贫血发生率更显著(P <.005)比另一组高。但两组患者在创面击破、中性粒细胞减少、血小板减少、化疗临床反应等方面均无显著差异。结论首次手术至开始辅助化疗的时间间隔对短期发病率无显著影响，但对生化(CA-125)反应有改善作用。

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引用次数: 0

Pegylated Liposomal Doxorubicin in Recurrent Ovarian Cancer: Is There a Role for Maintenance Therapy? 聚乙二醇化脂质体阿霉素治疗复发性卵巢癌:是否有维持治疗的作用?

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2014.06.007

Beth Cronin , Katina Robison , Christina Raker , Richard Moore , Cornelius O. Granai , Don S. Dizon

Introduction

Ovarian cancer is the fifth leading cause of death in women. PLD has been effective in recurrent ovarian cancer, but the ideal treatment length is unknown. We hypothesized that patients with regression or stabilization of disease while receiving PLD, who continued with prolonged treatment, would have increased PFS.

Patients and Methods

A retrospective chart review was performed of women with recurrent ovarian, fallopian tube, primary peritoneal, or uterine papillary serous carcinoma, who received 6 or more cycles of PLD without evidence of progression. Evaluation for progression was based on carcinoma antigen 125, physical examination, and imaging studies.

Results

Of the 30 patients meeting criteria for inclusion, 13 patients (43%) stopped treatment at best response (median, 6 cycles) and 17 (57%) continued treatment until disease progression (median, 11 cycles). Patients treated to best response experienced a significantly shorter PFS compared with those who continued treatment until progression, median 10 versus 15 months (P = .009). There was a trend toward improved OS in the prolonged therapy group of 42.5 months (range, 12-84) versus 23 months in the standard therapy group (range, 17-98; P = .56).

Conclusion

Our data suggest that prolonged PLD treatment to progression is associated with a PFS advantage compared with treatment to best response. In the absence of toxicity, this treatment paradigm should be considered.

卵巢癌是妇女死亡的第五大原因。PLD对复发性卵巢癌有效，但理想的治疗时间尚不清楚。我们假设，在接受PLD治疗时病情消退或稳定的患者，如果继续延长治疗，PFS会增加。患者和方法回顾性回顾了复发性卵巢、输卵管、原发性腹膜或子宫乳头状浆液性癌的女性，这些女性接受了6个或更多周期的PLD，没有进展的证据。评估进展是基于癌抗原125、体格检查和影像学检查。在符合纳入标准的30例患者中，13例(43%)患者在最佳缓解时停止治疗(中位数，6个周期)，17例(57%)患者继续治疗直至疾病进展(中位数，11个周期)。与继续治疗直至进展的患者相比，获得最佳缓解的患者的PFS显著缩短，中位数为10个月vs 15个月(P = 0.009)。延长治疗组42.5个月(范围12-84)有改善OS的趋势，而标准治疗组为23个月(范围17-98;P = .56)。结论:我们的数据表明，与治疗至最佳反应相比，延长PLD治疗至进展与PFS优势相关。在没有毒性的情况下，应该考虑这种治疗模式。

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引用次数: 4

Management of a Female Adnexal Tumor of Probable Wolffian Origin Complicated by Intercurrent Disseminated Intravascular Coagulation 一例可能起源于沃尔夫犬的女性附件肿瘤并发并发弥散性血管内凝血的治疗

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2014.06.005

John V. Brown III , Veronica Rausei-Mills , Christopher P. Crum , Bram H. Goldstein

引用次数: 0

Outcomes for Women Receiving Bevacizumab for Treatment of Ovarian Cancer Versus Other Solid Tumors at an Academic Oncology Center 在学术肿瘤中心接受贝伐单抗治疗卵巢癌与其他实体肿瘤的妇女的结局

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2013.12.004

Katina Robison , Courtney Olson , Bachir J. Sakr , Tina Rizack , Robert Legare , Ashley Stuckey , C.O. Granai , Don S. Dizon

Background

The main objective of this study was to determine the incidence of severe toxicity associated with bevacizumab use in women with ovarian cancer compared with that in women with other solid tumors.

Patients and Methods

This retrospective cohort study was performed by evaluating women treated with single-agent or combination bevacizumab in the Program in Women's Oncology between January 2004 and May 2009. Data was collected from electronic and office-based medical records. Toxicity was assessed according to the National Cancer Institute's Common Toxicity Criteria version 3.0 guidelines. A total of 103 women were treated with bevacizumab: 41 women (40%) with ovarian cancer and 62 (60%) with other solid tumors.

Results

There was no increase in the number of toxic effects seen in patients treated for ovarian cancer versus other tumor types. However, GI perforations were seen in 7.3% of women with ovarian cancer, whereas none were seen in those treated for other cancers (P = .06). More than 1 bevacizumab-related toxic effect (hazard ratio [HR], 2.74; 95% CI, 1.35-5.55) and treatment with bevacizumab after 3 prior lines of chemotherapy (HR, 2.44; 95% CI, 1.159-5.129) were associated with an increase in mortality in women with ovarian cancer. We found no significant difference in the incidence of bevacizumab-related toxicities when comparing ovarian cancer to other cancers. However, ovarian cancer patients did appear to have a statistically nonsignificant higher percentage of GI perforations.

Conclusion

Further studies evaluating patient factors associated with increased risk of toxicities may be warranted to assist with appropriate patient selection prior to bevacizumab use.

本研究的主要目的是确定贝伐单抗在卵巢癌女性患者中的严重毒性发生率，并与其他实体肿瘤女性患者进行比较。患者和方法本回顾性队列研究评估了2004年1月至2009年5月在女性肿瘤学项目中接受单药或联合贝伐单抗治疗的女性。数据是从电子病历和办公室病历中收集的。毒性根据美国国家癌症研究所的通用毒性标准3.0版指南进行评估。共有103名妇女接受了贝伐单抗治疗:41名(40%)患有卵巢癌，62名(60%)患有其他实体瘤。结果与其他肿瘤类型相比，卵巢癌患者的毒性作用数量没有增加。然而，7.3%的卵巢癌患者出现了胃肠道穿孔，而在接受过其他癌症治疗的患者中没有出现(P = 0.06)。多于1个贝伐单抗相关毒性效应(风险比[HR]， 2.74;95% CI, 1.35-5.55)和既往3次化疗后使用贝伐单抗治疗(HR, 2.44;95% CI, 1.159-5.129)与卵巢癌患者死亡率增加相关。我们发现卵巢癌与其他癌症相比，贝伐单抗相关毒性发生率无显著差异。然而，卵巢癌患者出现胃肠道穿孔的比例在统计上并不显著。结论:在使用贝伐单抗之前，有必要进一步研究评估与毒性风险增加相关的患者因素，以帮助患者进行适当的选择。

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引用次数: 1

Low-Grade Astrocytoma Arising in a Mature Ovarian Teratoma in an Adolescent 青少年成熟卵巢畸胎瘤中出现的低度星形细胞瘤

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2014.06.001

Yousef R. Badran , Fatima N. Obeidat , Mazen A. Freij

引用次数: 3

Optimization Program of Diagnostic, Therapeutic, and Rehabilitation Measures for the Cervical Background Diseases and Precancer 子宫颈背景病和癌前病变诊断、治疗和康复措施优化方案

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2014.02.001

Badretdinova F. Flarida, Shamil K. Gantsev, Vladimir B. Trubin

引用次数: 0

Analysis of Late Radiation Proctitis Among Patients Treated for Cervical Cancer: A Comparative Study Between Linear Accelerator and Cobalt Teletherapy 宫颈癌放射治疗晚期直肠炎的分析:直线加速器与钴离子远程治疗的比较研究

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2014.03.001

Kannan Ram Abhinav, M.G. Janaki, T.R. Arul Ponni, A.S. Kirthi Koushik, S. Mohan Kumar, Alva Ram Charith, Harjani Ritika, S. Arvind

Background

Concerns have been raised over adequate target volume coverage with conventional 2-dimensional planning owing to wide variations in pelvic anatomy between individual patients. To improve tumor volume coverage, increasing numbers of patients are being treated with 3-dimensional conformal radiotherapy (3DCRT), resulting in increased treatment volume as opposed to conventional planning. This study compares the occurrence of late radiation proctitis among patients with carcinoma of the cervix treated with 3DCRT using a linear accelerator (LINAC) versus conventional therapy using a telecobalt unit.

Patients and Methods

A total of 66 patients with carcinoma of the cervix treated with curative intent between August 2006 and August 2012, having a minimum of 6 months of posttreatment follow-up, were reviewed retrospectively. Whole-pelvis irradiation was administered in cobalt teletherapy using the box-field technique (33 patients) or using 3DCRT on a 6-MV LINAC (33 patients), followed by low-dose-rate intracavitary brachytherapy to a dose of 30 Gy.

Results

The median ages of patients treated on cobalt teletherapy and LINAC were 50 and 52 years, respectively, and the median follow-up durations were 24 and 18 months, respectively. Seven patients (21%) developed radiation proctitis in the cobalt teletherapy arm, compared with 12 patients (36%) in the LINAC arm (P = .03; χ² test).

Conclusion

There is a significant increase in the incidence of late radiation proctitis in patients treated with the 3DCRT technique compared with the conventional technique. The effect of associated factors such as rectal dose during brachytherapy needs to be studied before a definitive conclusion can be drawn.

背景:由于个体患者的骨盆解剖结构差异很大，传统的二维规划对足够的靶体积覆盖提出了担忧。为了提高肿瘤体积覆盖率，越来越多的患者正在接受三维适形放疗(3DCRT)治疗，导致与传统计划相反的治疗体积增加。本研究比较了使用直线加速器(LINAC) 3DCRT治疗的宫颈癌患者与使用远程钴单元的常规治疗的晚期放射性直肠炎的发生率。患者和方法回顾性分析2006年8月至2012年8月期间66例以治愈为目的的宫颈癌患者，治疗后随访至少6个月。采用盒场技术(33例)或在6 mv LINAC上使用3DCRT(33例)进行全骨盆放射治疗，然后进行低剂量率腔内近距离放射治疗，剂量为30 Gy。结果采用钴离子远程治疗和LINAC治疗的患者中位年龄分别为50岁和52岁，中位随访时间分别为24个月和18个月。在钴离子远程治疗组中，有7名患者(21%)发生放射性直肠炎，而在LINAC组中，有12名患者(36%)发生放射性直肠炎(P = 0.03;χ2检验)。结论3DCRT技术治疗晚期放射性直肠炎的发生率明显高于常规技术。近距离放射治疗中直肠剂量等相关因素的影响需要进一步研究才能得出明确的结论。

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引用次数: 0

The Effect of Obesity on the Time to Recurrence in Ovarian Cancer: A Retrospective Study 肥胖对卵巢癌复发时间影响的回顾性研究

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2014.02.002

Karina E. Hew , Arvind Bakhru , Evan Harrison , Mehmet O. Turan , Ryan MacDonald , Dwight D. Im , Neil B. Rosenshein

Introduction/Background

The objective of this study was to examine whether obesity affects the time to recurrence in primary epithelial ovarian cancer.

Patients and Methods

A multicenter retrospective chart review was performed between 2004 and 2009. Three hundred seventy patients were eligible for analysis. Demographic and clinicopathological variables and treatment-related data were collected. Women with a body mass index (BMI) > 30 were categorized as obese. The time to recurrence was quantified in terms of months. Survival analyses were performed using the Kaplan-Meier method and compared using log-rank testing.

Results

One hundred thirty (35%) obese patients were compared with 240 (65%) nonobese patients. A recurrence was documented in 125 (47.9%) nonobese patients and 49 (37.7%) obese patients. Time to recurrence between both BMI groups was identical, at 15 months (P = 1.0). The progression-free survival was similar in obese and nonobese subjects (P = .118).

Conclusion

Obesity does not affect the recurrence time in patients with primary ovarian cancer.

本研究的目的是探讨肥胖是否会影响原发性上皮性卵巢癌的复发时间。患者和方法2004 - 2009年进行多中心回顾性图表分析。370名患者符合分析条件。收集人口统计学和临床病理变量以及治疗相关数据。有身体质量指数(BMI)的女性;30人被归类为肥胖。复发时间以月为单位量化。生存分析采用Kaplan-Meier法，比较采用log-rank检验。结果肥胖患者130例(35%)，非肥胖患者240例(65%)。125例(47.9%)非肥胖患者和49例(37.7%)肥胖患者复发。两个BMI组的复发时间相同，均为15个月(P = 1.0)。肥胖和非肥胖受试者的无进展生存期相似(P = 0.118)。结论肥胖对原发性卵巢癌患者的复发时间无影响。

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引用次数: 5

Survival Outcomes of Clinical Trials in Patients With Recurrent Cervical Cancer 宫颈癌复发患者临床试验的生存结局

Clinical Ovarian and Other Gynecologic Cancer

Pub Date : 2013-12-01 DOI: 10.1016/j.cogc.2014.06.004

Christa I. Nagel, William N. Denson, Debra L. Richardson, Siobhan M. Kehoe, David S. Miller, Jayanthi S. Lea

Introduction

A large proportion of patients with cervical cancer have a lower socioeconomic background with inherent barriers to clinical trial participation. The present authors hypothesized that patients participating in a clinical trial would have better outcomes compared with those not enrolled in a trial. The objective was to review the clinical outcomes of women with recurrent cervical cancer treated on a clinical trial versus those treated off trial.

Patients and Methods

This was a retrospective cohort study of women treated for recurrent cervical cancer on versus off clinical trial between 1998 and 2010. Women participating in Gynecologic Oncology Group clinical trials for recurrent cervical cancer were identified and matched 1:1 with women treated off trial based on age within 10 years, ethnicity, stage at initial diagnosis, histology, primary treatment, and baseline renal function.

Results

A total of 60 women with recurrent cervical cancer were identified; 30 were treated for their recurrence on a clinical trial and were matched to 30 treated off trial. The median number of salvage regimens was 1.0 for the trial group (range, 1-5) and 1.5 for the off-trial group (range, 1-5) (P = .74). There was no significant difference in the number of cycles of chemotherapy completed on versus off trial (7.5 vs. 5.9; P = .44). There was also no significant difference in progression-free and overall survival from time of recurrence on trial and off trial (4.2 vs. 3.1 months [P = .75] and 15.0 vs. 13.8 months [P = .64], respectively).

Conclusion

This study found that the progression-free survival and overall survival are similar between women treated with chemotherapy on or off trial for cervical cancer.

很大一部分宫颈癌患者的社会经济背景较低，这对参与临床试验具有固有的障碍。目前的作者假设，参加临床试验的患者比没有参加试验的患者有更好的结果。目的是回顾在临床试验中接受治疗的复发性宫颈癌妇女与在试验外接受治疗的妇女的临床结果。患者和方法这是一项回顾性队列研究，对1998年至2010年期间接受复发性宫颈癌治疗的妇女进行了对照临床试验。参与妇科肿瘤学组复发性宫颈癌临床试验的妇女根据10年内的年龄、种族、初诊阶段、组织学、初次治疗和基线肾功能，与试验外治疗的妇女进行1:1匹配。结果共发现60例宫颈癌复发妇女;其中30人在临床试验中接受复发治疗，30人在试验外接受治疗。试验组救助方案的中位数为1.0个(范围，1-5)，非试验组为1.5个(范围，1-5)(P = 0.74)。试验前后完成化疗的周期数无显著差异(7.5 vs 5.9;P = .44)。试验前后的无进展生存期和总生存期也无显著差异(分别为4.2个月对3.1个月[P = 0.75]和15.0个月对13.8个月[P = 0.64])。结论本研究发现宫颈癌患者化疗前后的无进展生存期和总生存期相似。

{"title":"Survival Outcomes of Clinical Trials in Patients With Recurrent Cervical Cancer","authors":"Christa I. Nagel, William N. Denson, Debra L. Richardson, Siobhan M. Kehoe, David S. Miller, Jayanthi S. Lea","doi":"10.1016/j.cogc.2014.06.004","DOIUrl":"10.1016/j.cogc.2014.06.004","url":null,"abstract":"<div><h3>Introduction</h3><p>A large proportion of patients with cervical cancer have a lower socioeconomic background with inherent barriers to clinical trial participation. The present authors hypothesized that patients participating in a clinical trial would have better outcomes compared with those not enrolled in a trial. The objective was to review the clinical outcomes of women with recurrent cervical cancer treated on a clinical trial versus those treated off trial.</p></div><div><h3>Patients and Methods</h3><p>This was a retrospective cohort study of women treated for recurrent cervical cancer on versus off clinical trial between 1998 and 2010. Women participating in Gynecologic Oncology Group clinical trials for recurrent cervical cancer were identified and matched 1:1 with women treated off trial based on age within 10 years, ethnicity, stage at initial diagnosis, histology, primary treatment, and baseline renal function.</p></div><div><h3>Results</h3><p>A total of 60 women with recurrent cervical cancer were identified; 30 were treated for their recurrence on a clinical trial and were matched to 30 treated off trial. The median number of salvage regimens was 1.0 for the trial group (range, 1-5) and 1.5 for the off-trial group (range, 1-5) (<em>P</em> = .74). There was no significant difference in the number of cycles of chemotherapy completed on versus off trial (7.5 vs. 5.9; <em>P</em> = .44). There was also no significant difference in progression-free and overall survival from time of recurrence on trial and off trial (4.2 vs. 3.1 months [<em>P</em> = .75] and 15.0 vs. 13.8 months [<em>P</em> = .64], respectively).</p></div><div><h3>Conclusion</h3><p>This study found that the progression-free survival and overall survival are similar between women treated with chemotherapy on or off trial for cervical cancer.</p></div>","PeriodicalId":100274,"journal":{"name":"Clinical Ovarian and Other Gynecologic Cancer","volume":"6 1","pages":"Pages 42-45"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cogc.2014.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88990992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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