Intensity-modulated radiotherapy combined with iodine-125 seed implantation in non-central recurrence of cervical cancer: A case report and literature review

Abstract

Recurrent cervical cancer is a clinically complex disease that is difficult to treat. There are numerous treatment options, but the results achieved by each are poor. External-beam radiation therapy of the pelvic lymph drainage area, in combination with intracavitary afterloading or the interstitial implantation of a radiation source (i.e., brachytherapy), are the current standard radiotherapy regimens used in high-risk clinical targets. However, there are few reports concerning the use of iodine-125 (125I) seed implantation brachytherapy in recurrent cervical cancer, and the effects of treatment and adverse reactions have not yet been systematically evaluated. In the present study one such case is reported, in which the patient was successfully treated with intensity-modulated radiotherapy (IMRT) in combination with 125I seed implantation. The patient, a 47-year-old woman, was initially diagnosed with International Federation of Gynecology and Obstetrics stage IB1 cervical cancer, and received a radical hysterectomy, left lateral adnexectomy and pelvic lymph node dissection. A follow-up examination 23 months later revealed vaginal invasion and a solitary lump in the cervical stump with a maximum diameter of 38 mm. The patient was subsequently diagnosed with recurrent cervical cancer and was treated with six cycles of docetaxel and nedaplatin chemotherapy, alongside IMRT and interstitial 125I seed implantation. At the point of manuscript submission, the patient's progression-free survival time was 33 months and long-term adverse reactions were acceptable. The response of this patient indicates that 125I seed implantation could be used as a complementary treatment for recurrent cervical cancer and may also prove to be a reliable means for the comprehensive treatment of primary cervical cancer, as the patient had characteristics similar to primary cervical cancer, although this hypothesis could not be confirmed in the present study.

MicroRNA‐374b inhibits cervical cancer cell proliferation and induces apoptosis through the p38/ERK signaling pathway by binding to JAM‐2

“…CC continues to be a clinically complex disease, placing significant health strains on women worldwide (Feng et al, 2017). During the present study, the TCGA database analysis was employed in order to detect miRNAs that were differentially expressed between CC tissues signaling (Parnell, Calleja-Macias, Kalantari, Grando, & Bernard, 2012).…”

Praeruptorin A Inhibits Human Cervical Cancer Cell Growth and Invasion by Suppressing MMP-2 Expression and ERK1/2 Signaling

“…Cervical cancer patients mainly die from disease recurrence or progression, despite the use of advanced chemotherapeutic treatments [ 1 ]. The high lethality is due to this cancer’s resistance to available chemotherapy agents, its unusual ability to adapt to radiotherapy [ 2 ], and the lack of alternative treatment options. Metastasis of cervical cancer to other sites, such as the lymph nodes, lung, bone, liver, and bowel, are critical factors that contribute to its high mortality rate [ 3 , 4 ].…”

miR‐4429 sensitized cervical cancer cells to irradiation by targeting RAD51

“…CC, responsible for a large proportion of tumor‐related deaths globally, is a commonly diagnosed malignancy among women (Ellenson & Wu, ; Jemal et al, ; Jin et al, ; Parkin et al, ). Although multiple treatments are accessible to CC patients at an early stage such as surgical dissection, radiotherapy, or chemotherapy (Feng et al, ), about 1/3 of the patients end up with recurrence (Goncalves et al, ). One of the major reasons for recurrence in CC patients is resistance to irradiation (Waggoner, ).…”

“…Cervical cancer (CC) is a familiar type of malignancy among women, accounting for a large proportion of global cancer‐related deaths (Ellenson & Wu, ; Jemal et al, ; Jin et al, ; Parkin, Bray, Ferlay, & Pisani, ). Although at an early stage, CC patients are accessible to treatments such as surgical dissection, radiotherapy, or chemotherapy (Feng et al, ), around one‐third of CC patients turn out to suffer from recurrence (Goncalves et al, ). Radiotherapy is an option for recurrent cases free from treatment history of irradiation (Rose et al, ).…”