[Evidence based of chemoradiotherapy in cervix carcinoma]

Cervical Cancer Staging in Saudi Arabia Clinicoradiological Correlation

Objective

The aim of this study was to compare the finding of pelvic MRI with clinical staging using cystoscopy and sigmoidoscopy for cervical cancer patients.

Method

We reviewed all patients with cervical cancer between January 2001 and December 2015. We correlate the clinical examination, cystoscopy, and sigmoidoscopy with MRI findings.

Result

A total of 152 patients were enrolled. 114 (74.9%) were with locally advanced cervix cancer. The true positives for MRI in the detection of parametrium were in 94 patients, with sensitivity, specificity, positive, PPV, and NPV of 72%, 82%, 96%, and 33%, respectively. The false negative of the MRI to detect the bladder invasion was 2. Nineteen patients reported having bladder invasion on MRI not confirmed by cystoscopy. None of the patients who had a negative rectal invasion by MRI were found to have rectal involvement by sigmoidoscopy with a specificity of 91%.

Conclusion

The combined MRI and clinical staging for parametrial evaluation should still be carried out for the staging of cervical cancer. However, in the absence of the bladder and the rectal invasion in the MRI, it will be safe to avoid the need for a cystoscopy and/or sigmoidoscopy for complete staging in the majority of patients with cervical cancer.

Cervical cancer in north-eastern Libya: 2000-2008

Libya is a country with a low population, listed under the EMRO. Using registers and patient records from a major primary oncology clinic, data was gathered from Libyan cervical cancer patients and various parameters were studied across 9 years. Out of 4,090 female cancer cases during the study period, 1.8% were cervical cancer (n = 74). The average age of presentation was 53 years, with most of the cases (60%, n = 44) being premenopausal. Approximately 65% (n = 48) of cervical cancer patients are diagnosed at later stages (i.e. stages III and IV). The majority of these cases are squamous cell carcinoma (83.8%, n = 62), while 16.2% (n = 12) were found to be adenocarcinoma. Patients with squamous cell carcinoma presented at later stages more often than those with adenocarcinoma. Human papilloma virus was strongly implicated in cervical cancer, with 94% (n = 63) of those who were tested being positive for HPV-16 (82.5%, n = 52) and HPV-18 (12.7%, n = 8). Diagnosis was most frequently made through biopsy (97.3%, n = 72) as opposed to Pap smears (2.7%, n = 2). Most Libyan patients were put through chemotherapy (75%, n = 55) and triple therapy (surgery with combined chemotherapy and radiotherapy) was the most common (38%, n = 28) modality of treatment. Comparisons were made between Libya and other nations, either in the developed world or neighbouring countries. The major problem of cervical cancer in Libya is delayed presentation and hence, all the recommendations focus on increased awareness for the populace, implementation of a national cancer control plan and a national screening programme.

Nanotechnology in oncology: Characterization and in vitro release kinetics of cisplatin-loaded albumin nanoparticles: Implications in anticancer drug delivery

Context:

Nanotechnology is an empowering technology that holds promise in cancer therapeutics by increasing the ratio of tumor control probability to normal tissue complication probability. It can increase the bioavailability of the drug at the target site, reduce the frequency of administration and reach otherwise lesser-accessible sites. The present study shows the feasibility of the cisplatin-loaded albumin nanoparticle as a sustained delivery system.

Aims:

Cisplatin is one of the most widely used chemotherapeutic agents for the treatment of malignant disorders. Conventional cisplatin formulation given as intravenous infusion has low bioavailability to the target organ in addition to significant side-effects, like ototoxicity and nephrotoxicity. The aim of this study was to develop a protein-based nanoparticulate system for sustained release of cisplatin.

Materials and Methods:

Nanoparticles were prepared by the coacervaton method of microcapsulation and chemical cross-linking with glutaraldehyde. Particle size was characterized by dynamic light scattering and transmission electron microscopy.

Results and Conclusions:

Using the coacervation method, nanoparticles of less than 70 nm diameter were produced. Drug encapsulation measured by ultraviolet spectroscopy varied from 30% to 80% for different ratios of cisplatin and protein. In vitro release kinetics shows that the nanoparticle-based formulation has biphasic release kinetics and is capable of sustained release compared with the free drug (80% release in 45 h). The study proves the feasibility of the albumin-based cisplatin nanoparticle formulation as a sustained release vehicle of cisplatin.