Definitive Concurrent Chemoradiotherapy in Cervical Cancer - a University of Malaya Medical Centre Experience

Zamaniah, W.I. Wan; Mastura, M.Y.; Phua, Chee Ee; Adlinda, A.; Marniza, S.; Rozita, AM

doi:10.7314/apjcp.2014.15.20.8987

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Multiple factors including bacteria, viruses, microbes, precocious sexuality, promiscuity, multiple birth, and genetic susceptibility can cause cervical lesions and even cervical cancer (Zamaniah et al, 2014;Zeng et al, 2014). Numerous epidemiologic and molecular biology studies have confirmed that the HPV is closely related to the occurrence and development of genital tract epithelial malignant tumors and precancerous lesions.…”

Section: Discussionmentioning

confidence: 99%

Correlation of E6 and E7 levels in high-risk HPV16 type cervical lesions with CCL20 and Langerhans cells

Jiang¹,

Xue²

2015

Genet. Mol. Res.

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ABSTRACT. The human papillomavirus (HPV)16 E6 and E7 correlation with chemokine ligand (CCL)20 expression and Langerhans cells (LCs) in cervical lesions was investigated. We enrolled 43 patients with surgically treated cervical lesions from the Department of Gynecology in our hospital, and 20 controls without cervical lesions. Subjects were divided by pathology: HPV16(-) and HPV16(+) normal cervical groups (N = 10 each), and HPV16(+) cervical intraepithelial neoplasia (CIN), cervical invasive carcinoma (N = 15 each), and in situ carcinoma (N = 13) groups. E6, E7, the LC surface marker CD1a, and CCL20 were analyzed by immunohistochemistry. E6 and E7 in HPV16-type lesions were correlated with CCL20 and LCs. The average high power field cell numbers of CD1a + LCs in the HPV(-) and HPV(+) normal cervix groups, and the CINI-II, CINIII in situ and cervical carcinoma groups were 22.89 ± 4.84, 13.7 ± 2.26, 9.2 ± 1.68, 5.9 ± 1.59, and 5.5 ± 1.58, respectively. Significant between-group differences existed except between cervical carcinoma and CINIII groups (P < 0.05). CCL20 + rates in each group were 70, 60, 60, 15.38, and 13.33%, respectively. E6/E7-positive expression rates in each group were 20/20, 66.7/66.7, 76.9/69.2, and 86.67/73.3%, respectively. CCL20 was positively correlated with CD1a (r = 0.649), and negatively correlated with E7 (r = -0.946) and E6 (r = -0.949). CD1a was negatively correlated with E6 (r = -0.632) and E7 (r = -0.632). Downregulation of CCL20 leading to LC decline is a key factor in cervical lesions. High-risk HPV-type lesions might inhibit the chemokine CCL20 through E6 and E7 to escape the immune response.

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Section: Discussionmentioning

confidence: 99%

Correlation of E6 and E7 levels in high-risk HPV16 type cervical lesions with CCL20 and Langerhans cells

Jiang¹,

Xue²

2015

Genet. Mol. Res.

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“…A significant proportion of our patients attend our centre from distant places and a gap between EBRT (external beam radiotherapy) and ICBT is frequently observed making treatment prolonged and protracted upto 10 weeks and beyond due to social reasons. Zamaniah et al (2014) observed that nearly 30% exceeded the recommended 7 weeks for treatment completion due to various reasons. It was hypothesised that a shorter treatment time within the tolerance limit will accomplish the RTOG/GOG (Gynaecologic Oncologgy Group) recommendations of overall treatment time and might improve treatment compliance.…”

Section: Impact Of Treatment Time On Chemoradiotherapy In Locallymentioning

confidence: 99%

Impact of Treatment Time on Chemoradiotherapy in Locally Advanced Cervical Carcinoma

Pathy

Kumar²,

Pandey³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Extended Field Radiotherapy With or Without Chemotherapy in Patients with Cervical Cancer and Positive Para-Aortic Lymph Nodes: a Single Institution Retrospective Review

Rozita²,

Adlinda³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Positive para-aortic lymph node (PALN) at diagnosis in cervical cancer patients confers an unfavorable prognosis. This study reviewed the outcomes of extended field radiotherapy (EFRT) and concurrent chemotherapy with extended field RT (CCEFRT) in patients with positive PALN at diagnosis. Materials and Methods: Medical records of 407 cervical cancer patients between 1st January 2002 to 31st December 2012 were reviewed. Some 32 cases with positive PALN were identified to have received definitive extended field radiotherapy with or without chemotherapy. Treatment outcomes, clinicopathological factors affecting survival and radiotherapy related acute and late effects were analyzed. Results: Totals of 13 and 19 patients underwent EFRT and CCEFRT respectively during the period of review. The median follow-up was 70 months. The 5-year overall survival (OS) was 40% for patients who underwent CCEFRT as compared to 18% for patients who had EFRT alone, with median survival sof 29 months and 13 months, respectively. The 5-years progression free survival (PFS) for patients who underwent CCEFRT was 32% and 18% for those who had EFRT. Median PFS were 18 months and 12 months, respectively. Overall treatment time (OTT) less than 8 weeks reduced risk of death by 81% (HR=0.19). Acute side effects were documented in 69.7% and 89.5% of patients who underwent EFRT and CCEFRT, respectively. Four patients (12.5%) developed radiotherapy late toxicity and there was no treatment-related death observed. Conclusions: CCEFRT is associated with higher 5-years OS and median OS compared to EFRT and with tolerable level of acute and late toxicities in selected patients with cervical cancer and PALN metastasis.

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Definitive Concurrent Chemoradiotherapy in Cervical Cancer - a University of Malaya Medical Centre Experience

Cited by 3 publications

References 23 publications

Correlation of E6 and E7 levels in high-risk HPV16 type cervical lesions with CCL20 and Langerhans cells

Correlation of E6 and E7 levels in high-risk HPV16 type cervical lesions with CCL20 and Langerhans cells

Impact of Treatment Time on Chemoradiotherapy in Locally Advanced Cervical Carcinoma

Extended Field Radiotherapy With or Without Chemotherapy in Patients with Cervical Cancer and Positive Para-Aortic Lymph Nodes: a Single Institution Retrospective Review

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