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ABSTRACT: BACKGROUND: This study was designed to evaluate the efficacy of definitive radiation therapy (RT) for invasive carcinoma of the vagina. METHODS: Twenty-six patients with invasive carcinoma of the vagina who received RT were studied retrospectively. The median age was 68 years. The pathologic subtype of vaginal carcinoma was squamous cell carcinoma in 24 patients, adenosquamous cell carcinoma in one patient, and adenocarcinoma in one patient. The distribution of clinical stage according to the International Federation of Gynecology and Obstetrics staging system was as follows: stage I, seven patients; stage II, 10 patients, stage III, seven patients; and stage IVA, two patients. Twenty patients received external beam radiation therapy (EBRT) combined with high-dose rate intracavitary brachytherapy (HDR-ICBT), and three received EBRT alone. The remaining three patients with stage I disease were given HDR-ICBT alone. The median dose was 50 Gy for EBRT, and 23 Gy for HDR-ICBT. Systemic chemotherapy was administered concurrently with RT to three patients. RESULTS: The median follow-up was 90 months. The initial rate of response to RT was 100%, and complete remission was attained in 21 patients (81%). The 5-year overall survival rate (OS) and the median survival time of the 26 patients were 57% and 97 months, respectively. The 5-year OS for the three patients who received HDR-ICBT alone was 100%. Severe toxicity occurred in three patients-grade 3 rectal hemorrhage in one, grade 3 cystitis in one, and grade 4 cystitis in one. CONCLUSIONS: Our results demonstrated that definitive RT with HDR-ICBT is effective for invasive carcinoma of the vagina, with acceptable toxicity.
International Journal of Clinical Oncology 02/2012; · 1.41 Impact Factor
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ABSTRACT: Adequate treatment for extremely advanced endometrial cancer is unknown. The purpose of this study was to clarify the prognosis of patients with stage IVB endometrial carcinoma and the validity of treatment. Furthermore, we evaluated whether there was a connection between the prognosis and the site of metastasis.
The prognoses of 55 patients with stage IVB endometrial carcinoma were studied with reference to the initial treatment method and the metastatic site at the time of the initial treatment.
The median survivals of the group of 35 patients who were initially treated with surgery and the group of 10 patients who underwent radiotherapy or chemotherapy as their initial treatment followed by surgery were 11.5 months and 9.5 months, respectively. The residual tumor diameter after surgery was precisely measured in 40 of these 45 patients. The prognosis was significantly better in the patients with a residual tumor diameter of less than 2 cm compared to those with a tumor diameter of 2 cm or greater, and the median survival periods in these two groups were 23.5 months and 11.5 months, respectively (P = 0.027). Furthermore, the prognosis of patients with lung metastasis was significantly better than that of patients with non-lung hematogenous metastasis; the median survival periods of these two groups were 18.5 months and 10.5 months, respectively (P = 0.014).
For operable patients, surgery as an initial treatment and reduction of the residual tumor size to less than 2 cm appeared to contribute to a better prognosis. In addition, conservative initial treatment and the presence of non-lung hematogenous metastasis were poor prognostic factors.
International Journal of Clinical Oncology 09/2009; 14(4):344-50. · 1.41 Impact Factor
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ABSTRACT: The Clinical test of sentinel nodes (SNs) in uterine cancer began recently, especially endometrial cancer. In relation to cervical cancer, the detection rate of SN ranged anywhere between 15% to 100% and likewise the sensitivity rate varied from 66% to 100%. Due to these inconclusive results, the data cannot be reliably used for clinical study purposes. Meanwhile, it should be noted that endometrial cancer research has just begun. The tracer used for detection can be roughly classified into an isotope method and a dye method. The isotope method shows a better detection rate, but it can supplemented by using together with the dye method. In Japan, the most commonly reported radiopharmaceutical agent is technetium-99m-labeled phytic acid isotope and 1% isosulfan blue as the dye. In conducting cervical cancer studies, there are many reports of utilizing technetium-99m-labeled phytic acid isotope, injected into 4 different areas of the cervix. Regarding research conducted for endometrial cancer, experiments range from direct injection into the uterine body, injections into the cervix, and hysteroscopic injection. Due to ambiguity in the results, additional clinical testing is required to gather more data.
Gan to kagaku ryoho. Cancer & chemotherapy 01/2005; 31(13):2199-202.
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Nippon rinsho. Japanese journal of clinical medicine 11/2004; 62 Suppl 10:418-21.
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Nippon rinsho. Japanese journal of clinical medicine 11/2004; 62 Suppl 10:154-7.
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Nippon rinsho. Japanese journal of clinical medicine 11/2004; 62 Suppl 10:338-41.
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Nippon rinsho. Japanese journal of clinical medicine 11/2004; 62 Suppl 10:342-5.
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ABSTRACT: We report here a terminally ill patient with uterine cervical cancer who developed a brief psychotic disorder after bereavement following the loss of three close friends also suffering from gynecological cancer. A 49-year-old housewife, who was diagnosed as having uterine cervical cancer and was receiving palliative care was referred for psychiatric consultation because of an abrupt onset of delusions, bizarre behavior, disorganized speech, and catatonic behavior. On psychiatric examination, she showed delusional thought and catatonic behavior. Laboratory data were unremarkable, as was brain MRI. She had no history of psychiatric illness or drug or alcohol abuse. After receiving haloperidol, psychiatric symptoms disappeared, and she returned to the previous level of functioning after 3 days. The patient explained that the death of three of her friend due to gynecological cancer was shocking event for her. She focused her attention on her own fears of dying from the same disease. Brief psychotic disorder in cancer patients is rare in the literature. However, our report of brief psychotic disorder associated with bereavement may highlight possible precipitating factors, which have not been adequately emphasized in the literature to date. From a clinical perspective, it would be informative for liaison psychiatrists to inquire about the patient's experience of loss of significant others with the same disease. This may provide useful information helpful to understanding the patient's conception of the disease process. Cancer patients' bereaving friends who had cancer is not rare in clinical settings. Therefore, medical staff should be mindful of interpersonal relationships between patients and bereavement arising from these relationships.
Supportive Care Cancer 08/2003; 11(7):491-3. · 2.60 Impact Factor
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ABSTRACT: To evaluate the usefulness of endometrial aspiration cytology for assessing malignant cells of extrauterine origin.
Endometrial cytology was performed on 224 patients with primary ovarian cancer, 10 with fallopian tube cancer and 45 with peritoneal tumors.
Of 224 patients with ovarian cancer, 53 (23.7%) had positive endometrial cytology. Positive rates were: stage I, 4.3%; stage II, 25.0%; stage III, 39.7%; stage IV, 34.5%. Histologic positive rates were: serous, 28.7%; mucinous, 11.4%; clear cell, 23.1%; endometrioid and unclassifiable adenocarcinomas, 28.0%. Of 5 patients with ovarian cancer, 2 were asymptomatic, but aspiration cytology was positive. Of 10 patients with fallopian tube cancer, 9 (90.0%) had positive endometrial cytology. The positive rate on endometrial cytology was 56.7% in stomach cancer, 60.0% in breast cancer and 20.0% in colon cancer. Of 1,209 women with stomach cancer, 30 (2.4%) displayed ovarian metastasis. Of these, 7 (23.3%) had Krukenberg's tumor; endometrial cytology was positive in 1 (14.3%). In 7 of 17 patients with positive endometrial cytology, clinical diagnosis was made before stomach cancer therapy.
Endometrial aspiration cytology is useful for identifying nongynecologic malignant cells, diagnosing ovarian and fallopian tube cancers, and determining peritoneal dissemination and metastasis originating from gastrointestinal and breast cancers.
Acta cytologica 51(4):533-40. · 0.49 Impact Factor
