The potential for radiation sensitizers and radiation protectors combined with radiation therapy in gynecologic cancer

Several prognostic factors in stages I B and II A cervical carcinoma have been widely studied to define groups of patients with a poor prognosis. Most of these factors are interrelated. The characteristics which should be regarded as main factors have not yet been defined, because the studies reported were based on mainly retrospective and non-randomized analysis. Reviewing the literature, lymph node metastasis, differentiation grade, tumor size, parametrial extension, lymphblood vessel invasion and cervical invasion seem to be prognostically important factors, which suggests that the subdivision of patients according to the FIG0 classification alone is inaccurate. It seems useful to define subgroups of patients according to tumor characteristics, determined after surgical treatment and accurate histologic examination of the surgical specimen. Patients with one or more of these tumor features need additional treatment to improve survival. The current treatment modalities, such as postoperative radiotherapy, have not been thoroughly evaluated, but doubt exists as to their efficacy. Data in the literature suggest that particularly patients with para-aortic or multiple pelvic lymph node metastasis (> 3) have already developed distant metastases at the time of primary treatment and therefore need adjuvant systemic therapy. Patients with tumors larger than 4 cm in diameter, differentiation grade III, lymph-blood vessel invasion or cervical invasion (of more than 70%) seem to have high recurrence rates at both pelvic and distant sites, indicating that there is also a need for better pelvic control.

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“…Recently developed modalities such as radiation sensitizers and protectors, hyperthermia or high LET particles seems promising [17,106,113,119].…”

Section: Discussionmentioning

confidence: 99%

A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy

Bommel¹,

Lindert²,

Kock³

et al. 1987

European Journal of Obstetrics & Gynecology and Reproductiv

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“…The possibility of using drugs which modify radiation response in the clinical treatment of cancer has received considerable attention (Huber, R. and Teichman, B. 1971), with numerous articles reviewing the current status of field (Berry, 1982;Brady et al, 1981;J. M. Brown, 1985;Fowler, 1981;Harris, 1979;Kim and Chu, 1981;Kligerman, 1982;Phillips, 1977Phillips, , 1981.…”

Section: Clinical Application Of Protectorsmentioning

confidence: 99%

Radiation Protectors: the Unexpected Benefits

Grdina

Sigdestad

1989

Drug Metabolism Reviews

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“…During recent years, a number of potent radiosensitizing drugs with a specific effect on hypoxic cells became available (1). Some of the sensitizers are being currently tested in clinical trials.…”

Section: Key Terms: Cervix Cancer Vascularitymentioning

confidence: 99%

A morphometric study of vascularization in uterine cervix cancers

Révész

Siracká

1984

Cytometry

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The stromal, parenchymal, and vascular cellular constituents were identified and their relative proportion determined in biopsy specimens derived from untreated uterine cervix carcinomas. In the stroma of the tumors that eventually responded well to radiation treatment resulting in a prolonged survival of the patients, the proportion of vascular cells was increased in comparison to the cases that were associated with a poor patient survival. The observations were interpreted in terms of the radiobiological oxygen effect reflecting the radiosensitivity variation of cells in tumor areas vascularized to varying extent. It was concluded that the determination of a tumor vascularity index as a routine parameter would be of a great prognostic value and would contribute to the characterization of individual tumors, leading to improved therapeutic efficiency.

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The potential for radiation sensitizers and radiation protectors combined with radiation therapy in gynecologic cancer

Cited by 8 publications

References 25 publications

A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy

A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy

Radiation Protectors: the Unexpected Benefits

A morphometric study of vascularization in uterine cervix cancers

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