Abstract:
OBJECTIVE:The goals of this study were to evaluate the feasibility of pelvic intensity-modulated radiotherapy (IMRT) in the adjuvant treatment of gynecologic malignancies and to compare the dose-volume histograms (DVHs) and determine the potential impact on acute and long-term toxicity based on the dose to target and nontarget tissues for both planning techniques. METHODS:Ten consecutive patients referred for adjuvant radiotherapy for gynecologic malignancies at the University of Pittsburgh School of Medicine and Magee-Womens Hospital were selected for CT-based treatment planning using the ADAC 3D version 4.2g and the NOMOS Corvus IMRT version 4.0. Normal tissues and critical structures were contoured on axial CT slices by both systems in conjunction with a gynecologic radiologist. These regions included internal, external, and common iliac nodal groups, rectum, upper 4 cm of vagina, bladder, and small bowel. Conventional treatment planning included 3D four-field box using 18-MV photons designed to treat a volume from the L(5)/S(1) border superiorly to the bottom of the ischial tuberosity on the AP/PA field and shaped blocks on the lateral fields to minimize the dose to the rectum and small bowel. A seven-field technique using 6-MV photons was used for IMRT. Restraints on small bowel for IMRT were set at 23.0 Gy +/- 5% and 35.0 Gy+/- 5% for the rectum and 37.5 Gy +/- 5% for the bladder while simultaneously delivering full dose (45.0 Gy) to the intrapelvic nodal groups in 1.8-Gy daily fractions. The dose-volume histograms where then compared for both treatment delivery systems. RESULTS:The volume of each organ of interest (small bowel, bladder, and rectum) receiving doses in excess of 30 Gy was compared in the 3D and IMRT treatment plans. The mean volume of small bowel receiving doses in excess of 30 Gy was reduced by 52% with IMRT compared with 3D. A similar advantage was noted for the rectum (66% reduction) and the bladder (36% reduction). The nodal regions at risk and the upper vagina all received the prescribed dose of 45.0 Gy. CONCLUSIONS:Intensity-modulated radiotherapy appears to offer several advantages over conventional 3D radiotherapy (3D CRT) planning for adjuvant radiotherapy for gynecologic malignancies. These include a significant reduction in treatment volume for bladder, rectum, and small bowel. It is anticipated that this reduction in volume of normal tissue irradiated would translate into overall reduction in acute and potentially late treatment-related toxicity. Prospective trials are necessary to better evaluate the advantages in a larger group of patients.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Heron DE,Gerszten K,Selvaraj RN,King GC,Sonnik D,Gallion H,Comerci J,Edwards RP,Wu A,Andrade RS,Kalnicki Sdoi
10.1016/s0090-8258(03)00461-xsubject
Has Abstractpub_date
2003-10-01 00:00:00pages
39-45issue
1eissn
0090-8258issn
1095-6859pii
S009082580300461Xjournal_volume
91pub_type
临床试验,杂志文章abstract:OBJECTIVE:A multicenter phase II trial was conducted to assess the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with high-dose-rate intracavitary brachytherapy (HDR-ICBT) using a low cumulative prescribed dose schedule in patients with locally advanced uterine cervical cancer. METHODS:The Japanese Gyne...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2012.04.036
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:Vaccination of young women (15-25 years of age) against human papillomavirus (HPV) has been shown to be very efficacious in preventing the development of moderate or severe cervical precancerous lesions associated with HPV-16 or -18. As the highest rates of new infections with high-risk (i.e., oncogenic) HPV ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.09.021
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Myxoid leiomyosarcoma (MLMS) of the vulva is a mesenchymal tumor with only five reported cases in the literature. CASE:We report an 85-year-old woman with a unilateral nonulcerating, painless vulvar mass. According to the patient, the mass slowly enlarged. Initial biopsies were benign. However, clinically, ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2004.10.013
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:To increase genetic counseling referrals for patients with newly diagnosed epithelial ovarian cancer (EOC). METHODS:A practice-gap analysis was performed after measuring baseline genetic counseling referral rates to identify barriers to referral from the multidisciplinary single institution EOC care group. A...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2018.01.033
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:The origins and clinical significance of endosalpingiosis (ES), ectopic tubal epithelium, are not well understood. These investigations aim to characterize ES as it relates to normal fallopian tube, ovarian surface and serous neoplasms. METHODS:A retrospective review of pathology reports from all prophylacti...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.12.007
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Transforming growth factor beta (TGF-beta) is a multifunctional cytokine that strongly inhibits epithelial cell growth. Disabling of TGF-beta signaling is thought to be involved in development of a variety of tumors in which abnormal expression or function of TGF-beta receptor plays critical roles. In the pre...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.04.031
更新日期:2005-09-01 00:00:00
abstract::From 1980 to 1987, 30 patients with FIGO clinical Stage II carcinoma of the endometrium were treated with 5000 cGy preoperative pelvic radiation therapy at Thomas Jefferson University Hospital. Patients with gross cervical disease received additional intracavitary irradiation with a tandem and ovoids for a combined to...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1016/0090-8258(92)90281-m
更新日期:1992-05-01 00:00:00
abstract::There have been nine cases reported in the English literature in which the finding of malignant cells on cervical/vaginal cytology led to the diagnosis of primary gastric cancer. We report on a patient with gastric carcinoma, metastatic to the cervix, in which the diagnosis was suspected by the finding of signet ring ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/0090-8258(90)90117-4
更新日期:1990-01-01 00:00:00
abstract::Between 1971 and 1979, seventy-four patients with metastatic or advanced recurrent sarcoma of uterine origin were treated with combination chemotherapy consisting of vincristine, actinomycin D, and cyclophosphamide (Cytoxan). The probability of survival at 2 and 5 years was 23 and 15%, respectively. The response rate ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(83)90078-1
更新日期:1983-04-01 00:00:00
abstract::The patient described synchronous mucinous tumors of the cervix and ovary and concurrent annular tubules, but without the classical stigmata of Peutz-Jeghers syndrome. The cervical tumor was an invasive mucinous adenocarcinoma with mixed components of minimal deviation and less-well-differentiated endometrioid morphol...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(91)90040-c
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Paranasal sinus metastasis following endometrial carcinoma is extremely rare and a reflection of disseminated disease. CASE:We report a case of a 72-year-old woman who presented ethmoid and sphenoid sinus metastasis, 14 months after total abdominal hysterectomy and bilateral salpingo-oophorectomy due to an ...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2004.04.005
更新日期:2004-07-01 00:00:00
abstract::Thirty-two patients with Stage III or IV epithelial ovarian cancer and residual tumor volumes in excess of 2 cm in diameter after initial debulking were treated with platinum and cyclophosphamide chemotherapy. Twenty-seven patients (84%) received at least six courses of chemotherapy. Six patients developed grade 3 or ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(87)90296-4
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVE:To compare the detection rate of genital human papillomavirus (HPV) infection in self- and physician-obtained samples. DESIGN:Systematic review and meta-analysis. DATA SOURCES:Studies published between 1966 and November 2005 identified through Medline and Embase that compared both sampling methods. MAIN OU...
journal_title:Gynecologic oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ygyno.2007.01.023
更新日期:2007-05-01 00:00:00
abstract:INTRODUCTION:The ability to minimize residual disease during primary cytoreductive surgery is the strongest predictor for improved overall survival in advanced ovarian cancer. But while the probability to achieve a macroscopic complete resection increases if surgery is preceded by neoadjuvant chemotherapy (NACT), survi...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.02.019
更新日期:2019-05-01 00:00:00
abstract::Human papillomaviruses (HPVs) are small double-stranded DNA viruses that infect the skin and internal squamous mucosae. These viruses were once considered to be the causal agent only of skin or genital warts--lesions of trivial significance. It turns out, however, that HPVs belong to a large virus family that includes...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2010.04.002
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To determine the proportion of endometrial cancer patients who can be safely prescribed community/home based unsupervised exercise. A better understanding of the physical dysfunction secondary to comorbidities among endometrial cancer patients would assist clinicians in delineating which patients to send to m...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2015.08.007
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:Abnormalities in the control of cell proliferation and apoptosis have been suggested to contribute to the development and progression of neoplasia. There are at least two pathways that activate apoptosis. The first is a mitochondria-dependent route governed by bcl-2 family proteins. The second is a parallel ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(03)00411-6
更新日期:2003-11-01 00:00:00
abstract::In epithelial ovarian cancer, solitary metastasis to and recurrences in the parenchyma of the spleen are rare in the absence of apparent disease in other sites. We report four patients who developed isolated, solitary splenic parenchymal recurrences of their epithelial ovarian adenocarcinomas and underwent a splenecto...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1993.1059
更新日期:1993-03-01 00:00:00
abstract::This article describes the first reported case of a primary transitional cell carcinoma of the renal pelvis metastatic to the ovary. The clinical presentation in our patient was similar to that of a primary ovarian carcinoma. The differential diagnosis of a primary or metastatic transitional cell carcinoma in the ovar...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(91)90281-9
更新日期:1991-05-01 00:00:00
abstract::Metastatic disease to the breast is often an unexpected diagnosis in a female who presents with a breast mass. The most important factor suggesting the appropriate diagnosis is a history of cancer. Correlation of mammographic and ultrasonographic findings may also raise the possibility of a metastatic mass. A well-def...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(92)90288-t
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVES:We assessed neoadjuvant intraarterial chemotherapy (NAC) followed by radical hysterectomy and/or radiotherapy in patients with locally advanced cervical cancer. METHODS:Over 5 years, 48 consecutive women with International Federation of Gynecology and Obstetrics stage IIb-IVa cervical cancer were enrolled. ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1998.4976
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Development of carcinoma in situ in a neovagina is rare. CASE:A case of carcinoma in situ of a neovagina complicated by recurrence after ablative therapy is discussed. Recurrence occurred within 4 months of initial therapy, and a total vaginectomy was performed after the patient declined other therapeutic o...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2000.6078
更新日期:2001-03-01 00:00:00
abstract::Experience with the P.A.S.-PORT, a peripherally implanted central venous access device, is evaluated in a retrospective review of 154 patients from July 1991 to June 1994. Blood could not be aspirated from six patients. Complications included temporary minor thrombophlebitis in seven patients (4.5%), symptomatic axill...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1996.0246
更新日期:1996-09-01 00:00:00
abstract::Aggressive tumor reduction surgery has been widely used in patients with advanced stage epithelial ovarian carcinoma before initiation of cytotoxic chemotherapy. No randomized controlled trial has been carried out to confirm the benefits of such procedures. To examine the role of cytoreductive surgery in the managemen...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1997.4839
更新日期:1997-11-01 00:00:00
abstract::Between 1972 and 1977, 141 patients with benign gynecologic disease and 149 patients with carcinoma of the cervix were evaluated with peritoneal fluid cytology at time of celiotomy. There was no positive cytology (malignant cells) in the benign disease group. The overall incidence of positive peritoneal cytology in th...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(84)90069-6
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVES:In preparation for the launch of a gynecologic oncology survivorship program, this study looked at the informational needs of women with gynecologic cancers. Although studies have touched on some of these needs, no published literature has investigated the comprehensive informational needs of gynecologic onc...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.10.030
更新日期:2012-03-01 00:00:00
abstract:PURPOSE:Intraperitoneal (IP) therapy improves survival compared to intravenous (IV) treatment for women with newly diagnosed, optimally cytoreduced, ovarian cancer. However, the role of IP therapy in recurrent disease is unknown. Preclinical data demonstrated IP administration of the proteasome inhibitor, bortezomib pr...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2017.03.013
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:The objective of this pilot study was to determine if frailty predicts surgical complications among elderly women undergoing gynecologic oncology procedures. METHODS:A cohort of gynecologic oncology patients age ≥ 65, undergoing surgery between March and December 2011 was identified. Frailty was evaluated u...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.04.019
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) mediates apoptosis via binding to death receptors and enhances the anti-tumor effect of conventional cancer therapies. We evaluated the efficacy of TRA-8, an agonistic antibody to DR5, combined with docetaxel and carboplatin in vitro in an intrap...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.11.046
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:Describing the pattern of and reasons for post-operative tumor residuals in patients with advanced epithelial ovarian cancer (AOC) operated in a specialized gynecologic cancer center following a strategy of maximum upfront debulking followed by systemic chemotherapy. METHODS:All consecutive AOC-patients trea...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2016.03.015
更新日期:2016-05-01 00:00:00