1
|
Isohashi F, Yoshida K, Murakami N, Masui K, Ishihara S, Ohkubo Y, Kaneyasu Y, Kinoshita R, Kotsuma T, Takaoka Y, Tanaka E, Nagao A, Ogawa K, Yamazaki H. Reirradiation for recurrent gynecologic cancer using high-dose-rate brachytherapy in Japan: A multicenter survey on practice patterns and outcomes. Radiother Oncol 2024; 195:110269. [PMID: 38583719 DOI: 10.1016/j.radonc.2024.110269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND AND PURPOSE The aim of the study is to examine the present status of reirradiation with high-dose-rate (HDR) brachytherapy for recurrent gynecologic cancer in Japan and to determine the role of this therapy in clinical practice. MATERIALS AND METHODS A retrospective multicenter chart review was performed for reirradiation for gynecologic cancer using HDR brachytherapy. Each center provided information on patient characteristics, treatment outcomes, and complications. RESULTS The study included 165 patients treated at 9 facilities from 2000 to 2018. The analysis of outcomes included 142 patients treated with curative intent. The median follow-up time for survivors was 30 months (range 1-130 months). The 3-year overall survival (OS), progression-free survival (PFS), and local control (LC) rates were 53 % (95 %CI: 42-63 %), 44 % (35-53 %), and 61 % (50-70 %) for cervical cancer; 100 % (NA), 64 % (30-85 %), and 70 % (32-89 %) for endometrial cancer; and 54 % (13-83 %), 38 % (6-72 %), and 43 % (6-78 %) for vulvar and vaginal cancer, respectively. In multivariate analysis, interval to reirradiation (<1 year) was a significant risk factor for OS, PFS and LC; Gross Tumor Volume (≥25 cm3) was a significant risk factor for OS. Toxicities were analyzed in all enrolled patients (n = 165). Grade ≥ 3 late toxicities occurred in 49 patients (30 %). A higher cumulative EQD2 (α/β = 3) was significantly associated with severe complications. CONCLUSION Reirradiation with HDR brachytherapy for recurrent gynecologic cancer is effective, especially in cases with a long interval before reirradiation.
Collapse
Affiliation(s)
- Fumiaki Isohashi
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Department of Radiation Oncology, Nara Medical University, Kashihara, Nara, Japan.
| | - Ken Yoshida
- Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan; Department of Radiology, Kansai Medical University Medical Center, Moriguchi, Osaka, Japan
| | - Naoya Murakami
- Department of Radiation Oncology, National Cancer Center Hospital, Tsukiji, Tokyo, Japan; Department of Radiation Oncology, Juntendo University, Hongo, Tokyo, Japan
| | - Koji Masui
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shunichi Ishihara
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan; Department of Radiology, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yu Ohkubo
- Department of Radiation Oncology, Saku Central Hospital Advanced Care Center, Saku, Nagano, Japan
| | - Yuko Kaneyasu
- Department of Radiation Oncology, National Hospital Organization Fukuyama Medical Center, Fukuyama, Hiroshima, Japan; Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, Hiroshima, Japan
| | - Rumiko Kinoshita
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Tadayuki Kotsuma
- Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan; Department of Radiation Oncology, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Yuji Takaoka
- Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan; Department of Radiology, Saito Yukoukai Hospital, Ibaraki, Osaka, Japan
| | - Eiichi Tanaka
- Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Ayaka Nagao
- Department of Radiation Oncology, National Cancer Center Hospital, Tsukiji, Tokyo, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hideya Yamazaki
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
2
|
Choi HJ, Lee YY, Choi CH, Kim TJ, Lee JW, Bae JH, Bae DS, Kim BG. Triplet chemotherapy vs doublet chemotherapy plus bevacizumab in metastatic, recurrent, and persistent cervical cancer. Curr Probl Cancer 2020; 44:100557. [PMID: 32067746 DOI: 10.1016/j.currproblcancer.2020.100557] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/21/2020] [Accepted: 01/28/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The effectiveness of paclitaxel-cisplatin-ifosfamide triplet regimen (TIP) was reported to be superior to that of paclitaxel-cisplatin doublet. However, the efficacy of paclitaxel-cisplatin-bevacizumab triplet (TPA) and TIP has not been compared. Here, we compared the efficacy and safety of TIP and TPA in patients with metastatic, recurrent, or persistent cervical cancer. METHODS We retrospectively reviewed the medical records of patients with recurrent, persistent, or metastatic cervical cancer who were at the Samsung Medical Center, Seoul, Korea between January 2005 and September 2018. Of the 161 patients included in the study, 92 had received TIP and 71 had received TPA. For the study, we compared the response rates, progression-free survival (PFS), overall survival (OS), and safety in the 2 treatment groups. RESULTS The response rates of patients who received TIP and TPA were comparable (64.1% vs 73.2%, P = 0.239). Histology (squamous vs nonsquamous) was the only prognostic factor that affected the response to therapy (odds ratio, 0.259; 95% confidence interval [CI], 0.119-0.562; P = 0.001). The PFS after TIP and TPA treatment was similar: 12.0 months (95%CI, 10.26-13.74) vs 11.5 months (95%CI, 10.18-12.83), respectively. In a Cox proportional hazard model, objective response to therapies was the only independent prognostic factor for both PFS and OS. However, different types of therapy (TIP vs TPA) did not affect the oncological outcomes for either PFS or OS. Although hematologic toxicity was significantly higher in the TIP-treated group than in the TPA-treated group, both regimens were safe and well-tolerated. CONCLUSIONS The effectiveness and safety of TIP was comparable to TPA in terms of response rates, survival, and adverse effects. TIP could be an effective alternative in the treatment of cervical cancer when TPA is contraindicated or unaffordable.
Collapse
Affiliation(s)
- Hyun-Jin Choi
- Department of Obstetrics and Gynecology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yoo-Young Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Chel Hun Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae-Joong Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong-Won Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Hye Bae
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Duk-Soo Bae
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
3
|
A novel miRNA identified in GRSF1 complex drives the metastasis via the PIK3R3/AKT/NF-κB and TIMP3/MMP9 pathways in cervical cancer cells. Cell Death Dis 2019; 10:636. [PMID: 31474757 PMCID: PMC6717739 DOI: 10.1038/s41419-019-1841-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 07/13/2019] [Accepted: 07/18/2019] [Indexed: 12/19/2022]
Abstract
microRNAs (miRNAs) play an important role in carcinogenesis. Typically, miRNAs downregulate the target expression by binding to the 3′ UTR of mRNAs. However, recent studies have demonstrated that miRNAs can upregulate target gene expression, but its mechanism is not fully understood. We previously found that G-rich RNA sequence binding protein (GRSF1) mediates upregulation of miR-346 on hTERT gene. To explore whether GRSF1 mediate other miRNA’s upregulation on their target genes, we obtained profile of GRSF1-bound miRNAs by Flag-GRSF1-RIP-deep sequencing and found 12 novel miRNAs, named miR-G. In this study, we focused on miR-G-10, which is highly expressed in cervical cancer tissues and cell lines and serum from patients with metastatic cervical cancer. miR-G-10 in cervical cancer cells significantly promoted migration/invasion and anoikis resistance in vitro and lung metastasis in vivo. Furthermore, miR-G-10 bound to the 3′ UTR of PIK3R3 and upregulated its expression to activate the AKT/NF-κB signal pathway in a GRSF1-dependent manner, whereas miR-G-10 suppressed TIMP3 in the AGO2 complex to modulate the MMP9 signaling pathway in cervical cancer cells. Taken together, our findings may provide a new insight into the upregulation mechanism mediated by miRNAs and a potential biomarker for cervical cancer.
Collapse
|
4
|
Abstract
OBJECTIVE To examine survival outcomes of women with recurrent cervical cancer who received salvage chemotherapy with modified dose-dense paclitaxel (MDDP) monotherapy (paclitaxel 80 mg/m, administered on day 1, 8, and 15 without day 22). MATERIALS AND METHODS A retrospective study was conducted to evaluate cause-specific survival after the first recurrence (SAR) of women with recurrent cervical cancer diagnosed between 2006 and 2014. Pooled analyses were performed to examine SAR in women who received MDDP monotherapy (n=17) for any treatment line, compared with those who received salvage chemotherapy with paclitaxel-doublet (n=18) and nonpaclitaxel regimens (n=52). RESULTS In the whole cohort, median SAR was 13.7 months including 63 (72.4%) events. MDDP monotherapy regimen was most commonly used in the second-line setting (35.3%) followed by the third/fourth lines (both, 23.5%). Among the women who received MDDP regimen, there were 6 (35.3%) women who received ≥6 cycles; there was 1 (5.9%) women who discontinued the regimen due to adverse effects (grade 3 transaminitis); regimen postponement was seen in 2 (1.4%) of 140 total cycles; and the response rate after the sixth cycle of this regimen was 29.4% (1 complete and 4 partial responses). On univariate analysis, MDDP usage had the highest 2-year SAR rate (MDDP 54.1%, paclitaxel-doublet 43.6%, and nonpaclitaxel regimens 28.1%; Ptrend=0.044). On multivariate analysis, MDDP monotherapy remained an independent prognostic factor for improved SAR compared with the nonpaclitaxel regimen (adjusted-hazard ratio, 0.50; 95% confidence interval, 0.26-0.95; P=0.036). CONCLUSION Our results suggested that MDDP monotherapy is a tolerable and relatively effective regimen for recurrent cervical cancer.
Collapse
|
5
|
Choi HJ, Paik ES, Choi CH, Kim TJ, Lee YY, Lee JW, Bae DS, Kim BG. Response to Combination Chemotherapy With Paclitaxel/Ifosfamide/Platinum Versus Paclitaxel/Platinum for Patients With Metastatic, Recurrent, or Persistent Carcinoma of the Uterine Cervix: A Retrospective Analysis. Int J Gynecol Cancer 2018; 28:1333-1341. [DOI: 10.1097/igc.0000000000001316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
ObjectivePaclitaxel/ifosfamide/cisplatin triplet has shown a higher response rate than paclitaxel/cisplatin doublet, but the toxicity profile hindered the use of the triplet regimen. In this study, we adjusted the dosage of the triplet regimen and introduced carboplatin in cisplatin-intolerable patients. We tested the efficacy and toxicity of the modified triplet regimen in patients with recurrent or persistent cervical cancer.Materials and MethodsWe retrospectively reviewed the medical records of patients with recurrent or persistent cervical cancer who were treated between 2003 and 2015 at Samsung Medical Center. Response rate, progression-free survival (PFS), overall survival (OS), and toxicity of paclitaxel/ifosfamide/platinum (TIP) and paclitaxel/platinum (TP) were compared.ResultsThe overall response rate of TIP was significantly higher than that of TP (52.7% vs 36.4%,P= 0.031). In the TP group, response rate was higher in patients with progression-free interval longer than 12 months (P= 0.028) and those with squamous cell histology (P= 0.028). In TIP group, patients with older than 50 years (P= 0.017), progression-free interval longer than 12 months (P= 0.046), and squamous cell carcinoma histology (P< 0.001) showed higher response rates; but TIP showed higher response on all occasions. Median OS and median PFS were similar for TP and TIP (OS, 22.43 months vs 18.5 months,P= 0.44; PFS, 6.37 months vs 8.3 months, P= 0.48).ConclusionsPaclitaxel/ifosfamide/platinum showed a higher response rate than TP in patients with recurrent cervical cancer without an increase in severe complications. Considering the high response rate, TIP may be an option for persistent or recurrent cervical cancer.
Collapse
|
6
|
Yoshida K, Suzuki S, Sakata J, Utsumi F, Niimi K, Yoshikawa N, Nishino K, Shibata K, Kikkawa F, Kajiyama H. The upregulated expression of vascular endothelial growth factor in surgically treated patients with recurrent/radioresistant cervical cancer of the uterus. Oncol Lett 2018; 16:515-521. [PMID: 29928441 DOI: 10.3892/ol.2018.8610] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/20/2017] [Indexed: 01/23/2023] Open
Abstract
Vascular endothelial growth factor (VEGF) inhibitors have been utilized for the treatment against advanced or recurrent cervical carcinoma as a novel therapeutic modality. However, the expression level of VEGF in post-radiotherapy relapsed/persistent cervical cancer remains to be elucidated. The aim of the present study was to investigate the expression of VEGF and associated molecules using tumor samples from patients with post-radiotherapy relapsed/persistent cervical cancer. From a database of 826 patients who were treated at our institution between 2003 and 2015, eight patients with post-radiotherapy relapsed/persistent cervical cancer were identified, and 20 patients who underwent initial surgery alone were used as a control. Using samples from these patients, the expression levels of VEGF-A, VEGF receptor-1 (VEGFR-1) and hypoxia inducible factor-1α (HIF-1α) were immunohistochemically categorized as negative or weakly, moderately, or strongly positive according to the size of the staining area, and intensity. In carcinoma cells, the expression levels of VEGF-A, VEGFR-1 and HIF-1α were significantly higher in post-radiotherapy relapsed/persistent cervical cancer compared with control patients (P=0.0003, 0.0003, and 0.0001, respectively). In stroma cells, similar tendencies with statistical significance were observed (P=0.0014 and P<0.0001, respectively). In addition, the expression levels of VEGF-A and VEGFR-1 in carcinoma cells were significantly correlated with each other (P<0.0001). A significantly higher expression of VEGF was identified in post-radiotherapy relapsed/persistent cervical cancer compared with typical specimens from cervical cancer. The findings provide a novel insight into the clinical treatment for recurrent/persistent cervical cancer using a VEGF antagonist.
Collapse
Affiliation(s)
- Kosuke Yoshida
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Showa-ku, Nagoya 466-8550, Japan
| | - Shiro Suzuki
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Showa-ku, Nagoya 466-8550, Japan
| | - Jun Sakata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Showa-ku, Nagoya 466-8550, Japan
| | - Fumi Utsumi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Showa-ku, Nagoya 466-8550, Japan
| | - Kaoru Niimi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Showa-ku, Nagoya 466-8550, Japan
| | - Nobuhisa Yoshikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Showa-ku, Nagoya 466-8550, Japan
| | - Kimihiro Nishino
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Showa-ku, Nagoya 466-8550, Japan
| | - Kiyosumi Shibata
- Department of Obstetrics and Gynecology, Banbuntane Hotokukai Hospital, Nakagawa-ku, Nagoya 454-8509, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Showa-ku, Nagoya 466-8550, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Showa-ku, Nagoya 466-8550, Japan
| |
Collapse
|
7
|
Zhou J, Chen Y, Xu X, Yan D, Lou H. Postoperative clinicopathological factors affecting cervical adenocarcinoma: Stages I-IIB. Medicine (Baltimore) 2018; 97:e9323. [PMID: 29480826 PMCID: PMC5943842 DOI: 10.1097/md.0000000000009323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Currently, cervical adenocarcinoma (ADC) receives the same standard treatment as squamous cell carcinoma, but this treatment regimen is not wholly suited for ADC. The present study was conducted to assess the prognostic role of postoperative clinicopathological factors in patients with stage I-IIB cervical ADC.The study examined 312 patients with stage I-IIB cervical ADC who underwent radical hysterectomy, including pelvic lymphadenectomy, at our institutions between October 2006 and September 2014. Overall survival (OS) and relapse-free survival (RFS) was analyzed by the Kaplan-Meier method. Sites of recurrence were classified as local and distant locations.The 5-year OS and RFS rates were 88.2% and 83.8%, respectively. The 5-year OS rates for patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA, IB, IIA, and IIB were 100.0%, 90.7%, 82.8%, and 55.6%, respectively. The Cox model identified number of positive pelvic nodes and age at surgery as independent prognostic factors for survival, and number of positive pelvic nodes and postoperative tumor diameter (≥4 cm) as independent prognostic factors for relapse. Cancer recurrence developed in 35 women. The top three recurrence sites were pelvis, vaginal stump, and lung.A more aggressive therapeutic strategy different from current practice in cervical cancer is urgently required for cervical ADC. As a new prognostic factor, postoperative tumor diameter should receive special attention in ADC treatment.
Collapse
Affiliation(s)
- Jiansong Zhou
- Key Laboratory of Radiation Oncology of Zhejiang Province
- Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital
| | - Yuanyuan Chen
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang, P.R. China
| | - Xiaoxian Xu
- Key Laboratory of Radiation Oncology of Zhejiang Province
- Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital
| | - Dingding Yan
- Key Laboratory of Radiation Oncology of Zhejiang Province
- Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital
| | - Hanmei Lou
- Key Laboratory of Radiation Oncology of Zhejiang Province
- Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital
| |
Collapse
|
8
|
Umezawa R, Murakami N, Nakamura S, Wakita A, Okamoto H, Tsuchida K, Kashihara T, Kobayashi K, Harada K, Takahashi K, Inaba K, Ito Y, Igaki H, Masui K, Yoshida K, Jingu K, Tselis N, Itami J. Image-guided interstitial high-dose-rate brachytherapy for locally recurrent uterine cervical cancer: A single-institution study. Brachytherapy 2017; 17:368-376. [PMID: 29275869 DOI: 10.1016/j.brachy.2017.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 10/26/2017] [Accepted: 11/21/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of this study was to investigate the efficacy and safety of image-guided high-dose-rate (HDR) interstitial brachytherapy (ISBT) for reirradiation of locally recurrent uterine cervical cancer. METHODS AND MATERIALS Between 2008 and 2015, patients receiving reirradiation using HDR-ISBT for local gross recurrence of uterine cervical cancer after definitive or postoperative radiotherapy were analyzed retrospectively. The prescription doses per fraction ranged 2.5-6.0 Gy, whereas the cumulative equivalent doses in 2 Gy fractions ranged 48.6-82.5 Gy. The effects of prognostic factors on the local control (LC), progression-free survival, and overall survival were analyzed, and late toxicity data were evaluated. RESULTS Eighteen patients were included in the analysis, with a median followup of 18.1 months. A tumor response was obtained in all patients, with radiological and pathological complete remission seen in 12 (66.7%) patients. The 2-year LC, progression-free survival, and overall survival rates for all patients were 51.3%, 20.0%, and 60.8%, respectively. The hemoglobin level and maximum tumor diameter were shown to be statistically significant prognostic factors for LC (p = 0.028 and 0.009, respectively). Late ≥ Grade 2 adverse events were observed in 5 patients (27.8%). CONCLUSIONS Image-guided HDR-ISBT for the reirradiation of locally recurrent uterine cervical cancer may play an important role for local tumor control in a subgroup of patients. However, the treatment indication must be weighed against the risk of higher-grade late toxicity.
Collapse
Affiliation(s)
- Rei Umezawa
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Naoya Murakami
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Satoshi Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Akihisa Wakita
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hiroyuki Okamoto
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Tairo Kashihara
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kazuma Kobayashi
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Ken Harada
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kana Takahashi
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Koji Inaba
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yoshinori Ito
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Koji Masui
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ken Yoshida
- Department of Radiology, Osaka Medical College Hospital, Osaka, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nikolaos Tselis
- Department of Radiotherapy and Oncology, University of Frankfurt, Frankfurt am Main, Germany
| | - Jun Itami
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| |
Collapse
|
9
|
Guo F, Fu X, Yang J, Zhang X, Liu D, Feng W, Liu J, Qi J, Cao H, Qi L, Ren J. Role of macrophage migration inhibitory factor in mesenchymal epithelial transition of cervical carcinoma cells. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:9621-9626. [PMID: 31966840 PMCID: PMC6965983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/20/2017] [Indexed: 06/10/2023]
Abstract
Cervical cancer is a kind of female malignant tumor with increasing incidence recently. Macrophage migration inhibitory factor (MIF) is a major tumor facilitating factor. The previous study suggests that there was a correlation between MIF and migration or invasion of tumors. Epithelial mesenchymal transition (EMT) is the basis for tumor invasion and migration. Therefore, this study utilized MFI to treat cervical carcinoma Hela cells, and the mechanism of EMT was also further analyzed. Cervical carcinoma Hela cells were transfected with pFenesil MIF siRNA plasmids, following by real-time fluorescent quantitative PCR to detect MIF levels. MTT assay was then utilized for evaluate the proliferative activity of Hela cells after transfection. The cell invasion and migration were examined. The expression of E-cadherin and Vimentin were also detected. The results indicated that the MIF was positively expressed in Hela cells, whose MIF mRNA level was increased after the transfection (P<0.05). Compared to the control or blank group, the transfected group had elevated proliferative activity with elongated incubation time (P<0.05). Both invasion and migration functions of transfected cells were significantly potentiated (P<0.05) compared to the control or blank group. E-cadherin expression level was also decreased in experimental group. MIF was also expressed in cervical carcinoma Hela cells. Elevated MIF level could facilitate the cell invasion and migration, and elevate the Vimentin and decrease E-cadherin expression, thus facilitating EMT.
Collapse
Affiliation(s)
- Fangfang Guo
- Edmond H. Fischer Signal Transduction Laboratory, School of Life Sciences, Jilin UniversityChangchun, Jilin, PR China
- Jilin Province Tumor HospitalChangchun, Jilin, PR China
| | - Xueqi Fu
- Edmond H. Fischer Signal Transduction Laboratory, School of Life Sciences, Jilin UniversityChangchun, Jilin, PR China
| | - Jili Yang
- Jilin Province Tumor HospitalChangchun, Jilin, PR China
| | - Xueying Zhang
- Jilin Province Tumor HospitalChangchun, Jilin, PR China
| | - Dezhi Liu
- Jilin Province Tumor HospitalChangchun, Jilin, PR China
| | - Wenjuan Feng
- Jilin Province Tumor HospitalChangchun, Jilin, PR China
| | - Jinyu Liu
- Jilin Province Tumor HospitalChangchun, Jilin, PR China
| | - Jinhong Qi
- Jilin Province Tumor HospitalChangchun, Jilin, PR China
| | - Huifang Cao
- Jilin Province Tumor HospitalChangchun, Jilin, PR China
| | - Li Qi
- Chaoyang District People’s Hospital of Jilin ProvinceChangchun, Jilin, PR China
| | - Jingyuan Ren
- Jilin Province Tumor HospitalChangchun, Jilin, PR China
| |
Collapse
|
10
|
Li S, Yang F, Wang M, Cao W, Yang Z. miR-378 functions as an onco-miRNA by targeting the ST7L/Wnt/β-catenin pathway in cervical cancer. Int J Mol Med 2017; 40:1047-1056. [PMID: 28902356 PMCID: PMC5593456 DOI: 10.3892/ijmm.2017.3116] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/25/2017] [Indexed: 01/08/2023] Open
Abstract
Upregulation or downregulation of microRNAs (miRNAs) has been identified in human cervical cancer (CC). However, the character and function of miR-378 in CC remains unknown. In the present study, the authors demonstrated that miR-378 was upregulated in CC used the reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) assay, and promoted cell proliferation by accelerating the progress of cell cycle and repressing cell apoptosis in CC cells. The predicted target genes of miR-378 were determined by enhanced green fluorescent protein (EGFP) reporter assays, RT-qPCR assay and western blot analysis. miR-378 suppressed the expression of suppression of tumorigenicity 7-like (ST7L) by targeting the 3′-untranslated region (3′-UTR) of ST7L mRNA in HeLa and SiHa cells. ST7L was downregulated in CC using the RT-qPCR assay, and the malignant phenotype of HeLa and SiHa cells were inhibited by ST7L overexpression. In addition, miR-378 activated the Wnt/β-catenin pathway by targeting ST7L in CC cells. In short, miR-378 functions as an onco-miRNA by directly downregulating ST7L mRNA and protein level in HeLa and SiHa cells, and serves important roles in the malignancy of CC.
Collapse
Affiliation(s)
- Shengjie Li
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, P.R. China
| | - Fengxia Yang
- Department of Clinical Laboratory, Xintai Affiliated Hospital of Taishan Medical University, Xintai, Shandong 271200, P.R. China
| | - Meiyan Wang
- Department of Clinical Therapeutics and Diagnostics (Theranostics), School of Pharmacy, Tianjin Medical University, Tianjin 300070, P.R. China
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, P.R. China
| | - Zhen Yang
- Department of Pathogen Biology, Basic Medical School, Tianjin Medical University, Tianjin 300070, P.R. China
| |
Collapse
|
11
|
Marth C, Landoni F, Mahner S, McCormack M, Gonzalez-Martin A, Colombo N. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017; 28:iv72-iv83. [PMID: 28881916 DOI: 10.1093/annonc/mdx220] [Citation(s) in RCA: 436] [Impact Index Per Article: 62.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- C Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - F Landoni
- Department of Gynecologic Oncology, European Institute of Oncology, Milan, Italy
| | - S Mahner
- Department of Gynecology and Obstetrics, University of Munich, Munich, Germany
| | - M McCormack
- Department of Oncology, University College Hospital, London, UK
| | - A Gonzalez-Martin
- Medical Oncology Department, MD Anderson Cancer Center, Madrid, Spain
| | - N Colombo
- Department of Gynecologic Oncology, European Institute of Oncology, Milan, Italy
| |
Collapse
|
12
|
Li QQ, Zhang L, Wan HY, Liu M, Li X, Tang H. CREB1-driven expression of miR-320a promotes mitophagy by down-regulating VDAC1 expression during serum starvation in cervical cancer cells. Oncotarget 2016; 6:34924-40. [PMID: 26472185 PMCID: PMC4741499 DOI: 10.18632/oncotarget.5318] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 10/02/2015] [Indexed: 12/21/2022] Open
Abstract
The altered expression of miRNAs in response to stresses contributes to cancer pathogenesis. However, little is known regarding the mechanism by which cellular stresses drive alterations in miRNA expression. Here, we found that serum starvation enhanced mitophagy by downregulating the mitophagy-associated protein voltage-dependent anion channel 1 (VDAC1) and by inducing the expression of miR-320a and the transcription factor cAMP responsive element binding protein 1(CREB1). Furthermore, we cloned the promoter of miR-320a and identified the core promoter of miR-320a in the upstream -16 to -130 region of pre-miR-320a. Moreover, CREB1 was found to bind to the promoter of miR-320a to activate its expression and to induce mitophagy during serum starvation. Collectively, our results reveal a new mechanism underlying serum starvation-induced mitophagy in which serum starvation induces CREB1 expression, in turn activating miR-320a expression, which then down-regulates VDAC1 expression to facilitate mitophagy. These findings may provide new insights into cancer cell survival in response to environmental stresses.
Collapse
Affiliation(s)
- Qin-Qin Li
- Tianjin Life Science Research Center and School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Le Zhang
- Tianjin Life Science Research Center and School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Hai-Ying Wan
- Tianjin Life Science Research Center and School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Min Liu
- Tianjin Life Science Research Center and School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Xin Li
- Tianjin Life Science Research Center and School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Hua Tang
- Tianjin Life Science Research Center and School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| |
Collapse
|
13
|
Jia Y, Chen J, Zhu H, Jia ZH, Cui MH. Aberrantly elevated redox sensing factor Nrf2 promotes cancer stem cell survival via enhanced transcriptional regulation of ABCG2 and Bcl-2/Bmi-1 genes. Oncol Rep 2015; 34:2296-304. [PMID: 26324021 DOI: 10.3892/or.2015.4214] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/05/2015] [Indexed: 11/06/2022] Open
Abstract
The presence of cancer stem cells in cervical cancer stem cells (CSCs) is important in the prevention of therapy failure and tumor recurrence. Upregulation of transcriptional regulation of redox sensing factor Nrf2 leads to the overexpression of drug efflux proteins such as ABCG2 in cancer stem cells and thus results in cancer treatment failure and cancer relapse. In the present study, we purified approximately 3.1% of cervical CSCs, which exhibited aberrant upregulation of Nrf2 in conjunction with an elevated transcriptional regulation of ABCG2, Bcl-2 and Bmi-1. Consequently, CSCs possess prolonged cell survival, infinite cell proliferation and highly resistant apoptosis. Following silencing of the function of Nrf2 the cervical CSCs became more sensitive to DNA targeting drugs and apoptosis. Our results suggested that Nrf2-mediated drug and apoptosis resistance are important in cancer therapies and tumor recurrence. Therefore, designing anticancer drugs targeting Nrf2 may be crucial to prevent CSC-mediated tumorigenesis.
Collapse
Affiliation(s)
- Yan Jia
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin Universty, Changchun, Jilin 130041, P.R. China
| | - Jun Chen
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin Universty, Changchun, Jilin 130041, P.R. China
| | - He Zhu
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin Universty, Changchun, Jilin 130041, P.R. China
| | - Zan-Hui Jia
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin Universty, Changchun, Jilin 130041, P.R. China
| | - Man-Hua Cui
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin Universty, Changchun, Jilin 130041, P.R. China
| |
Collapse
|
14
|
Dang YP, Yuan XY, Tian R, Li DG, Liu W. Curcumin improves the paclitaxel-induced apoptosis of HPV-positive human cervical cancer cells via the NF-κB-p53-caspase-3 pathway. Exp Ther Med 2015; 9:1470-1476. [PMID: 25780454 PMCID: PMC4353755 DOI: 10.3892/etm.2015.2240] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 12/18/2014] [Indexed: 12/21/2022] Open
Abstract
Paclitaxel, isolated from Taxus brevifolia, is considered to be an efficacious agent against a wide spectrum of human cancers, including human cervical cancer. However, dose-limiting toxicity and high cost limit its clinical application. Curcumin, a nontoxic food additive, has been reported to improve paclitaxel chemotherapy in mouse models of cervical cancer. However, the underlying mechanisms remain unclear. In this study, two human cervical cancer cell lines, CaSki [human papilloma virus (HPV)16-positive] and HeLa (HPV18-positive), were selected in which to investigate the effect of curcumin on the anticancer action of paclitaxel and further clarify the mechanisms. Flow cytometry and MTT analysis demonstrated that curcumin significantly promoted paclitaxel-induced apoptosis and cytotoxicity in the two cervical cell lines compared with that observed with paclitaxel alone (P<0.05). Reverse transcription-polymerase chain reaction indicated that the decline of HPV E6 and E7 gene expression induced by paclitaxel was also assisted by curcumin. The expression levels of p53 protein and cleaved caspase-3 were increased significantly in the curcumin plus paclitaxel-treated HeLa and CaSki cells compared with those in the cells treated with paclitaxel alone (P<0.01). Significant reductions in the levels of phosphorylation of IκBα and the p65-NF-κB subunit in CaSki cells treated with curcumin and paclitaxel were observed compared with those in cells treated with paclitaxel alone (P<0.05). This suggests that the combined effect of curcumin and paclitaxel was associated with the NF-κB-p53-caspase-3 pathway. In conclusion, curcumin has the ability to improve the paclitaxel-induced apoptosis of HPV-positive human cervical cancer cell lines via the NF-κB-p53-caspase-3 pathway. Curcumin in combination with paclitaxel may provide a superior therapeutic effect on human cervical cancer.
Collapse
Affiliation(s)
- Yu-Ping Dang
- Department of Dermatology, Air Force General Hospital of People's Liberation Army, Beijing 100142, P.R. China
| | - Xiao-Ying Yuan
- Department of Dermatology, Air Force General Hospital of People's Liberation Army, Beijing 100142, P.R. China
| | - Rong Tian
- Department of Dermatology, Air Force General Hospital of People's Liberation Army, Beijing 100142, P.R. China
| | - Dong-Guang Li
- Department of Dermatology, Air Force General Hospital of People's Liberation Army, Beijing 100142, P.R. China
| | - Wei Liu
- Department of Dermatology, Air Force General Hospital of People's Liberation Army, Beijing 100142, P.R. China
| |
Collapse
|
15
|
Kajimoto E, Hashimoto H, Isaka S, Yokoi T, Ogita K, Nagamatsu M. Combination chemotherapy with paclitaxel, ifosfamide, and cisplatin for mature cystic teratoma with malignant transformation: a case report. Int Cancer Conf J 2014. [DOI: 10.1007/s13691-014-0158-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
16
|
A systematic review comparing cisplatin and carboplatin plus paclitaxel-based chemotherapy for recurrent or metastatic cervical cancer. Gynecol Oncol 2014; 133:117-23. [PMID: 24486604 DOI: 10.1016/j.ygyno.2014.01.042] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 01/20/2014] [Accepted: 01/23/2014] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The prognosis of advanced/recurrent cervical cancer patients is generally poor with 1-year survival ranging between 15 and 20%. Cisplatin (CDDP) based treatments are considered the most effective regimens; unfortunately toxicity is an issue in a population in which the treatment remains palliative in the finality. Carboplatin (CBDCA), with its more favorable non toxicity profile and the convenience of outpatient administration, may be a suitable alternative to CDDP in combination regimens. MATERIALS AND METHODS We performed a systematic review of the literature comparing CDDP and CBDCA based chemotherapy for advanced cervical cancer (recurrent, persistent or metastatic disease). Only studies that met the following criteria were considered for the present review: 1) patients treated with CDDP/paclitaxel or CBDCA/paclitaxel combinations as first line chemotherapy for metastatic disease; 2) one or more of the following data available: overall response rate (RR), progression free survival (PFS) or time to progression (TTP), overall survival (OS); 3) single-arm retrospective or prospective study; and 4) at least 20 patients enrolled. RESULTS 17 eligible studies comprehensive of 1181 patients were included in the final analysis. The objective RR was 48.5% for CBDCA and 49.3% for CDDP-based chemotherapy. Median PFS for CDDP and CBDCA-based treatments was 6.9months and 5months respectively (p=0.03); the corresponding figures for median OS were 12.87 and 10months respectively (p=0.17). DISCUSSION Our study indicates that CBDCA may represent an attractive and valid alternative to the more toxic and equally effective CDDP in the treatment of advanced or recurrent cervical cancer.
Collapse
|
17
|
Yang L, Wang YL, Liu S, Zhang PP, Chen Z, Liu M, Tang H. miR-181b promotes cell proliferation and reduces apoptosis by repressing the expression of adenylyl cyclase 9 (AC9) in cervical cancer cells. FEBS Lett 2013; 588:124-30. [PMID: 24269684 DOI: 10.1016/j.febslet.2013.11.019] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 11/07/2013] [Indexed: 10/26/2022]
Abstract
MicroRNAs are a class of small, endogenous, non-coding RNAs that function as post-transcriptional regulators. In this study, we found that miR-181b promoted cell proliferation and inhibited cell apoptosis in cervical cancer cells. And we validated a new miR-181b target gene, adenylyl cyclase 9 (AC9). miR-181b restricted cAMP production by post-transcriptionally downregulating AC9 expression. Phenotypic experiments indicated that miR-181b and AC9 exerted opposite effects on cell proliferation and apoptosis.
Collapse
Affiliation(s)
- Lei Yang
- Tianjin Life Science Research Center, Department of Microbiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yan-Li Wang
- Tianjin Life Science Research Center, Department of Microbiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Shang Liu
- Tianjin Life Science Research Center, Department of Microbiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Pei-Pei Zhang
- Tianjin Life Science Research Center, Department of Microbiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Zheng Chen
- Tianjin Life Science Research Center, Department of Microbiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Min Liu
- Tianjin Life Science Research Center, Department of Microbiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Hua Tang
- Tianjin Life Science Research Center, Department of Microbiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
| |
Collapse
|
18
|
Platinum-free Interval in Second-line Chemotherapy for Recurrent Cervical Cancer. Int J Gynecol Cancer 2013; 23:1670-4. [DOI: 10.1097/igc.0b013e3182a80a07] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ObjectiveThe purpose of this study was to determine whether the platinum-free interval (PFI) was a predictive indicator in second-line treatment of cervical cancer in patients who had undergone prior platinum-based chemotherapy. The role of the PFI in selecting the second-line regimen in other gynecologic malignancies is also discussed.MethodsIn this retrospective study, we examined the clinical records of patients with recurrent or metastatic cervical cancer who had received platinum-containing combination regimens as second-line chemotherapy. All patients had received prior platinum-containing chemotherapy or concurrent chemoradiotherapy.ResultsThe overall response rate to second-line chemotherapy was 25.8%; 7 patients achieved a complete response and 17 a partial response. The median progression-free survival (PFS) was 5.1 months and median overall survival (OS) was 13.5 months. The response rate was 12.5%, 14.2%, 20.0%, 22.2%, and 55.0%; median PFS was 4.0, 5.1, 4.4, 5.8, and 7.4 months; and median OS was 10.2, 14.4, 11.9, 16.3, and 19.7 months when PFI was within 3, 3 to 5, 6 to 11, 12 to 23, and more than 24 months, respectively. Age (>50 years), size (>3 cm), prior radiotherapy, and PFI (>24 months) were identified as prognostic factors in the multivariate analysis for PFS and OS.ConclusionsThe results indicate that a PFI of more than 24 months is the discriminating point between platinum-sensitive and platinum-resistance cervical cancer. This indicates that PFI offers a useful tool in selecting agents for second-line chemotherapy in a wide range of gynecologic malignancies.
Collapse
|
19
|
Li S, Hu T, Chen Y, Zhou H, Li X, Cheng X, Yang R, Wang S, Xie X, Ma D. Adjuvant chemotherapy, a valuable alternative option in selected patients with cervical cancer. PLoS One 2013; 8:e73837. [PMID: 24058496 PMCID: PMC3772826 DOI: 10.1371/journal.pone.0073837] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 07/22/2013] [Indexed: 11/19/2022] Open
Abstract
Radiotherapy is the standard treatment for cervical cancer, but causes radiotherapy-induced complications. Recently, chemotherapy has been more extensively utilized. Here, we perform a large-scale comparison of chemotherapy and radiotherapy. From 2002 to 2008, 2,268 patients were grouped according to adjuvant radiotherapy or chemotherapy before and/or after surgery, and we compared the 5-year overall survival (OS) and disease-free survival (DFS) rates, recurrence rates, side effects, quality of life (QoL), and sexual activity. There were no significant differences between the treatment groups for the 5-year OS and DFS rates (OS: p = 0.053, DFS: p = 0.095), although marginally improved outcomes were observed in the chemotherapy group (OS: 86.5% vs. 82.8%; DFS: 84.5% vs. 81.4%). However, patients with early-stage disease, clinical response, and younger age had increased 5-year OS and DFS rates following chemotherapy compared to radiotherapy (p<0.05). The chemotherapy group exhibited significantly lower 5-year recurrence and distant failure rates compared to the radiotherapy group (p<0.001 and p = 0.007, respectively). Nausea and vomiting were the most frequent short-term complications of chemotherapy, whereas bowel and urinary complications were more frequent in the radiotherapy group. Compared to the chemotherapy group, patients who received radiotherapy reported a lower QoL, less frequent sexual activity, and more severe menopausal symptoms (p<0.05). Cervical cancer patients treated with chemotherapy, especially those with early-stage disease, clinical responses, and younger ages, have more positive outcomes, fewer complications, better QoL and sexual activity, suggesting that chemotherapy may be a valuable alternative option for selected patients.
Collapse
MESH Headings
- Adult
- Carcinoma, Small Cell/mortality
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/surgery
- Carcinoma, Small Cell/therapy
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Carcinoma, Squamous Cell/therapy
- Chemotherapy, Adjuvant
- Databases, Factual
- Female
- Humans
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Neoplasm Recurrence, Local/therapy
- Quality of Life/psychology
- Radiotherapy, Adjuvant
- Sexual Behavior
- Surveys and Questionnaires
- Survival Analysis
- Treatment Outcome
- Uterine Cervical Neoplasms/mortality
- Uterine Cervical Neoplasms/pathology
- Uterine Cervical Neoplasms/surgery
- Uterine Cervical Neoplasms/therapy
Collapse
Affiliation(s)
- Shuang Li
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Ting Hu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Yile Chen
- Department of Gynecologic Neoplasms, Hunan Province Tumor Hospital, The Affiliated Tumor Hospital of Central South University, Changsha, People’s Republic of China
| | - Hang Zhou
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Xiong Li
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Xiaodong Cheng
- Women’s Reproductive Health Laboratory of Zhejiang Province, Zhejiang, P.R. China
| | - Ru Yang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Shixuan Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
- * E-mail: (SW); (XX); (DM)
| | - Xing Xie
- Women’s Reproductive Health Laboratory of Zhejiang Province, Zhejiang, P.R. China
- * E-mail: (SW); (XX); (DM)
| | - Ding Ma
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
- * E-mail: (SW); (XX); (DM)
| |
Collapse
|
20
|
Ohara T, Kobayashi Y, Yoshida A, Yoshioka N, Yahagi N, Kondo H, Tozawa A, Kiguchi K, Suzuki N. Combination of irinotecan (CPT-11) and nedaplatin (NDP) for recurrent patients with uterine cervical cancer. Int J Clin Oncol 2012; 18:1102-6. [PMID: 23095879 DOI: 10.1007/s10147-012-0487-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 10/03/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND The clinical activity of combination of irinotecan (CPT-11) and nedaplatin (NDP) for recurrent patients with uterine cervical cancer was evaluated retrospectively. METHODS Intravenous CPT-11 was given at 60 mg/m(2) (days 1, 8, 15), followed by NDP 80 mg/m(2) (day 1), every 4 weeks. RESULTS According to the medical records, 29 cases have received this regimen since 2000. Median age was 57 years (range, 29-80), and performance status (PS) of the patients was 18 cases with PS 0, 10 cases with PS 1, and 1 case with PS 2, respectively. Clinical stage was as follows: 3 cases of stage Ib1, 2 cases of Ib2, 2 cases of IIa, 10 cases of IIb, 8 cases of IIIb, and 4 cases of IVb. There were 27 cases of squamous cell carcinoma and 2 cases of adenocarcinoma. Concerning hematological toxicity of grade 3 or more, neutropenia, leukopenia, and febrile neutropenia were observed in 79.3 %, 96.6 %, and 13.8 % of cases, respectively. For nonhematological toxicity, nausea, anorexia, joint pain, and confusion were observed in only 1 case, respectively, and as a result, in 7 cases chemotherapy was not completed. Among 26 cases with clinically evaluable lesions, there were 7 complete responses, 3 partial responses, 7 stable disease, and 9 progressive disease; the clinical response rate was 38.5 %. Median progression-free survival was 7 months (range, 0-38 months). CONCLUSION The combination of CPT-11 and NDP seems to be active for patients with recurrent uterine cervical cancer.
Collapse
Affiliation(s)
- Tatsuru Ohara
- Department of Obstetrics and Gynecology, School of Medicine, St. Marianna University, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Evaluation of paclitaxel/carboplatin in a dose dense or weekly regimen in 66 patients with recurrent or primary metastatic cervical cancer. Eur J Cancer 2012; 48:1332-40. [DOI: 10.1016/j.ejca.2012.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 12/31/2011] [Accepted: 01/04/2012] [Indexed: 11/18/2022]
|
22
|
Zhang SL, Wang YS, Zhou T, Yu XW, Wei ZT, Li YL. Isolation and characterization of cancer stem cells from cervical cancer HeLa cells. Cytotechnology 2012; 64:477-84. [PMID: 22431223 DOI: 10.1007/s10616-012-9436-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Accepted: 02/07/2012] [Indexed: 11/29/2022] Open
Abstract
Cervical cancer is one of the most common gynecologic malignancies and poses a serious health problem worldwide. Identification and characterization of cervical cancer stem cells may facilitate the development of novel strategies for the treatment of advanced and metastatic cervical cancer. Breast cancer-resistance protein (Bcrp1)-positive cells were selected from a population of parent HeLa cells using flow cytometry. The invasion capacity of Bcrp1-positive and -negative cells was analyzed with a Boyden chamber invasion test. The tumorigenicity of these cells was determined by in vivo transplantation in non-obesity diabetes/severe combined immunodeficiency (NOD/SCID) mice. The Bcrp1-positive subpopulation accounted for about 7% of the parent HeLa cell population. The proliferative capacity of the Bcrp1-positive cells was greater than that of the Bcrp1-negative cells (P < 0.05). In the invasion assay, the Bcrp1-positive cells demonstrated a greater invasive capacity through the artificial basement membrane than their Bcrp1-negative counterparts. Following transplantation of 10(4) cells, only the Bcrp1-positive cells formed tumors in NOD/SCID mice. When 10(5) or 10(6) cells were transplanted, the tumor incidence and the tumor mass were greater in the Bcrp1-positive groups than those in the Bcrp1-negative groups (P < 0.05). The Bcrp1-positive subpopulation cervical cancer stem cells.
Collapse
Affiliation(s)
- Song-Ling Zhang
- Department of Gynecology and Obstetrics, First Hospital of Jilin University, Xinmin Street 71-1, Changchun, 130021, People's Republic of China,
| | | | | | | | | | | |
Collapse
|
23
|
Kosmas C, Vorgias G, Tsakonas G, Politis P, Daladimos T, Panagiotidi E, Papachrysanthou T, Moschovis D, Kalinoglou N, Tsavaris N, Karabelis A, Mylonakis N. Paclitaxel-ifosfamide-carboplatin combination chemotherapy regimen in advanced uterine and adnexal malignant mixed Mullerian tumours. Br J Cancer 2011; 105:897-902. [PMID: 21847127 PMCID: PMC3185936 DOI: 10.1038/bjc.2011.316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Malignant mixed Mullerian tumours (MMMTs) of the uterus and adnexa represent aggressive gynaecologic malignancies with a high rate of loco-regional and distant failure. For that reason, we evaluated the paclitaxel–ifosfamide–carboplatin (TICb) combination in patients with advanced MMMTs. Methods: Female patients with advanced MMMTs, WHO-PS 0–2, no prior chemotherapy for systemic disease, unimpaired haemopoietic and organ function were eligible. Chemotherapy was administered at the following doses; paclitaxel: 175 mg m–2 on day 1, ifosfamide: 2.0g m–2 day–1 – days 1 and 2, and carboplatin at a target area under the curve 5 on day 2, with prophylactic G-CSF from day 3. Results: Forty patients of a median age 61 (45–72) years, performance status 0–2 with advanced MMMTs of the uterus (n=34), tubes (n=2) or ovary (n=4) have entered and all were evaluable for response and toxicity. Responses were as follows: 27 out of 40 (67.5%) evaluable patients responded, with 11 complete responses and 16 partial responses, while 10 had stable disease, and 3 developed progressive disease. The median response duration was 9 months (range, 4–40 months), median progression-free survival 13 months (range, 3–42 months), while median overall survival 18 months (range, 4–48 months). Grade 3/4 neutropenia was recorded in 22 out of 40 (55%) – with 13 developing grade 4 (⩽7 days) and 7 out of 40 (17.5%) of patients at least one episode of febrile neutropenia. Conclusion: In this study, it appears that the TICb combination, yielded important activity with manageable toxicity in females with advanced MMMTs warranting further randomised comparison with current standard regimens.
Collapse
Affiliation(s)
- C Kosmas
- Second Division of Medical Oncology, Department of Medicine, Metaxa Cancer Hospital, Piraeus, Greece.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Lin JT, Shih SC, Chang TH, Chang CS. Docetaxel, carboplatin and 5-fluorouracil (TCF) chemotherapy in patients with unresectable metastatic carcinoma of cervix. Gynecol Oncol 2010; 117:65-9. [PMID: 20106511 DOI: 10.1016/j.ygyno.2010.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Revised: 12/26/2009] [Accepted: 01/04/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This retrospective study evaluates the efficacy and safety of chemotherapy with docetaxel, carboplatin and 5-FU (TCF) in patients with metastatic cervical carcinoma. METHODS Between January 2006 and April 2007, 23 patients with metastatic cervical carcinoma were included in the study. Patients fulfilling the following criteria were enrolled: histologically confirmed metastatic cervical carcinoma; documented progressive disease (PD) after cisplatinum-based treatment if applicable; an Eastern Cooperative Oncology Group (ECOG) performance scale of 0-2; not candidates for local therapy; measurable metastatic lesions as assessed by the Response Evaluation Criteria in Solid Tumors (RECIST); and adequate hematologic, hepatic, and renal functions. Treatment consisted of intravenous docetaxel at 60 mg/m(2) diluted in 500 ml 5% glucose administered over 1 h on day 1, followed by carboplatin (AUC of 5 or 6) given as a 1-h intravenous infusion delivered on day 2, followed by 5-FU at 500 mg/m(2) diluted in 500 ml normal saline continuously infusion for 24 h for 2 days on day 2. Chemotherapy was repeated every 21 days, and a total of 1-5 courses were performed. RESULTS There were 3 (13%) complete responses; 4(17%) partial responses; 6 (26%) with stable disease, and 10 (43%) with disease progression. The overall response rate was 56%. After a median follow-up of 16 months, the median overall survival was 12 months. Neutropenia was the most severe toxicity. CONCLUSIONS The combination of docetaxel, carboplatin and 5-fluorouracil (TCF) appears to have activity in metastatic cervical carcinoma with acceptable toxicity profile.
Collapse
Affiliation(s)
- Jen-Tsun Lin
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
| | | | | | | |
Collapse
|