Southern African Journal of Gynaecological Oncology最新文献

{"title":"The impact of HIV infection on women receiving radiation for cervical cancer","authors":"M. Mangena, L. Snyman, G. Dreyer, S. Bassa, P. Becker","doi":"10.1080/20742835.2015.1083697","DOIUrl":"https://doi.org/10.1080/20742835.2015.1083697","url":null,"abstract":"Abstract Background: The objective of the study was to compare patient characteristics, treatment toxicity and interruptions, and survival in human immunodeficiency virus (HIV)-positive and HIV-negative cervical cancer patients receiving radiation as primary or adjuvant treatment. Method: Demographics, clinical and tumour characteristics, and the outcomes of 51 HIV-positive and 47-HIV negative consecutive cervical cancer patients were assessed and compared, including co-morbidities, performance status, treatment type and toxicities, and survival. Results: HIV-positive women were 13 years younger (p < 0.001), more often had anaemia (p 0.021) and needed pretreatment blood transfusion (p 0.037) more often than HIV-negative women. Performance status, kidney function, International Federation of Gynecology and Obstetrics stage, histology types and treatment intent and planning did not differ between the two groups. Treatment interruptions (p 0.004), transfusion during treatment (p 0.012), treatment toxicities (p 0.040) and average deficit (p 0.021) occurred significantly more in HIV-positive patients. Survival was significantly worse in HIV-positive women (p 0.029) and was associated with insufficient radiation (p < 0.001) and treatment interruptions (p 0.051). Conclusion: In spite of being younger, the pretreatment correction of anaemia and the prescription of sufficient radiation dosages, HIV-infected cervical cancer patients experienced poorer survival. Treatment interruption and incomplete radiation contributed to poor outcomes.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"7 1","pages":"44 - 51"},"PeriodicalIF":0.3,"publicationDate":"2015-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2015.1083697","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal colour Doppler ultrasound in predicting response to chemoradiation in patients with carcinoma of the cervix","authors":"M. Mangla, D. Singla","doi":"10.1080/20742835.2015.1083722","DOIUrl":"https://doi.org/10.1080/20742835.2015.1083722","url":null,"abstract":"Abstract Background: The objective of the study was to evaluate the potential role of transvaginal colour Doppler ultrasound (TVCDUS) in predicting response to chemoradiotherapy in patients with locally advanced cervical cancer. Method: TVCDUS was used in 56 patients with histologically proven cervical carcinoma (stage IIA–IIIB) before the start of chemoradiation, and after one and three months of therapy. Resistive index (RI) and pulsatality index (PI) were calculated using TVCDUS. Tumour response to chemotherapy was determined. Complete response was when no residual tumour was found, partial response if the tumour volume decreased by more than 50%, and no response when there was no appreciable change in the size of tumour, or the tumour volume decreased to less than 50% of the original volume. Results: A statistically significant increase in RI and PI was demonstrated with TVCDUS following treatment in patients who had a complete and partial response to chemoradiation, compared to those who had no response. Conclusion: TVCDUS is useful in predicting clinical response to concurrent chemoradiation in patients with locally advanced cervical cancer. Thus, it is recommended during the pretreatment evaluation and follow-up.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"7 1","pages":"68 - 72"},"PeriodicalIF":0.3,"publicationDate":"2015-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2015.1083722","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cobalt-60 is a logical, economical and comparable alternative to Ir-192: analysis and institutional experience from western India","authors":"Upendra Nandwana, N. Rathore, Sunnia Gupta, A. Shukla, Satish Kumar, Kiran Intodia, Poonam Chand Bana, A. Jain","doi":"10.1080/20742835.2015.1083720","DOIUrl":"https://doi.org/10.1080/20742835.2015.1083720","url":null,"abstract":"Abstract Objectives: The objective of the study was to examine the dosimetry of intracavitary radiotherapy (ICRT) in carcinoma of the cervix using cobalt-60 (Co-60) as source of ICRT, and as an alternative to iridium-192 (Ir-192). Design: This was a retrospective study. Subjects and setting: The study was on 80 ICRT patients attending the radiotherapy department at Maharana Bhupal Government Hospital, Udaipur, India. Outcome measures: The dosimetry of ICRT was studied retrospectively in 80 related applications. The dose to point A, 60 Gy isodose reference volume, and bladder and rectum maximum and mean doses were defined. Results: It was found that dosimetry with Co-60 as a brachytherapy source was consistent with the International Commission on Radiation Units (ICRU 38) recommendations. Conclusion: Co-60 is a logical alternative to Ir-192 in low socio-economic settings when repeated changing of the source is not an option.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"7 1","pages":"60 - 63"},"PeriodicalIF":0.3,"publicationDate":"2015-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2015.1083720","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant treatment, tumour recurrence and the survival rate of uterine serous carcinomas: a single-institution review of 62 women","authors":"F. Pol, D. Allen, R. Bekkers, P. Grant, S. Hyde","doi":"10.1080/20742835.2015.1030891","DOIUrl":"https://doi.org/10.1080/20742835.2015.1030891","url":null,"abstract":"Abstract Objectives: The aim of this study was to assess our department’s management of uterine serous carcinoma (USC) and to determine the correlation of the recurrence and survival rates of stage I-IV patients with different adjuvant treatment modalities. Design: A retrospective, single-institution, observational cohort study was performed. Subjects and setting: The study participants were women diagnosed with stage I-IV USC between 1996 and 2012 at the Mercy Hospital for Women, Heidelberg, Australia. Outcome measures: Outcomes measures were tumour recurrence rates, relapse-free survival and overall survival relating to the different adjuvant treatment modalities. Method: A retrospective, single-institution study on 62 women with stage I-IV USC diagnosed between 1996 and 2012 was performed. Results: Thirty patients had stage I, 5 stage II, 16 stage III and 11 stage IV, disease. Twenty patients received no adjuvant treatment, 19 patients adjuvant radiotherapy, 13 adjuvant chemotherapy and 10 adjuvant chemoradiation. Thirty-two (52%) patients experienced a recurrence and 32 patients were deceased, of whom 29 deaths were USC related. Recurrence risk correlated with stage (p-value 0.000). Early-stage (I and II) disease was associated with significant better relapse-free survival and overall survival than advanced-stage (III and IV) disease (p-value 0.000 and p-value 0.001, respectively). Adjuvant treatment significantly improved relapse-free survival and overall survival (p-value 0.008 and p-value 0.020, respectively), compared to no adjuvant treatment. Furthermore, a statistically significant improvement in relapse-free survival (p-value 0.035) and a trend towards better overall survival (p-value 0.064) was demonstrated with chemotherapy. Conclusion: USC has a high recurrence rate and overall prognosis is poor. The stage of disease seems to be the best predictor of prognosis. This study suggests that even patients with early-stage (I and II) disease, i.e. either pure or mixed USC, should receive adjuvant treatment, as all of these women have a significantly high risk of recurrence. Currently, radiotherapy and chemotherapy are the adjuvant therapies used for USC. Prospective studies may help to determine the most effective adjuvant therapies.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"7 1","pages":"14 - 20"},"PeriodicalIF":0.3,"publicationDate":"2015-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2015.1030891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of patients with cancer of the cervix attending a radiotherapy outpatient department: experience from a university-based hospital in eastern Uttar Pradesh, India","authors":"M. Nandi, A. Mandal, A. Asthana","doi":"10.1080/20742835.2015.1083680","DOIUrl":"https://doi.org/10.1080/20742835.2015.1083680","url":null,"abstract":"Abstract Objective: A retrospective analysis of all patients with cancer of the cervix attending a radiotherapy outpatients department in a single unit from January 2005 to December 2006 was carried out to study their epidemiology, stage and status of presentation, compliance with treatment and follow-up, as well as response and complication rates. Design: This was a retrospective study. Setting and subjects: Four hundred and ninety-five consecutively registered patients with cancer of the cervix were included in the study, which was carried out between January 2007 and December 2008. Outcome measures: The epidemiology, stage and status of presentation, compliance with treatment and follow-up, as well as the response and complication rates of the treated patients were the outcome measures. Results: Most of the patients hailed from the various districts of Uttar Pradesh (58%) and Bihar (32%), India. The majority (> 50%) were aged 40-59 years. Stage information was available for 70% of the patients, of which stage 1 comprised 5%, stage 2, 36%; stage 3, 56%; and stage 4, 3%. Squamous cell carcinoma was the most common reported histopathology (~90%). A significant proportion of the women defaulted after registration, or after undergoing investigations (34%). Of the 65% cases planned for treatment, 50% initiated it, but only 35% completed it, according to protocol. Radical radiotherapy was planned for the majority of women (>90%) with or without chemotherapy. Compliance with follow-up was poor (26%). At the time of the analysis, 63% patients had a complete response, 12% residual disease, 16% progressive disease and 7% locoregional recurrence. Recorded late complications were mostly grade I and II bladder and rectal toxicity. Conclusion: The outcome of this study will significantly help us to define region-specific strategies needed for the management of cervical cancer in eastern Uttar Pradesh, India.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"7 1","pages":"12 - 5"},"PeriodicalIF":0.3,"publicationDate":"2015-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2015.1083680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epithelioid trophoblastic tumour: a report of two cases","authors":"M. Elhassan, H-T Wu, A. V. van Wijk","doi":"10.1080/20742835.2015.1030893","DOIUrl":"https://doi.org/10.1080/20742835.2015.1030893","url":null,"abstract":"An epithelioid trophoblalstic tumour (ETT) is an extremely rare form of gestational trophoblastic disease (GTD). 1 Usually, patients are of child-bearing age with a prior gestation. 2 The uterus is the most common site for an ETT. 3 This tumour has the same clinical behaviour as that of a placental site trophblastic tumour, but the treatment options may differ. Histologically, an ETT is a distinct neoplasm whose cytological features and growth patterns mimic those of squamous cell carcinoma. 3 An ETT does not appear to be as chemosensitive as other GTDs, making hysterectomy the treatment of choice in patients with disease confined to the uterus. 3 This tumour may present a diagnostic challenge to the pathologist, while clinicians often face problems with treating this tumour because of its rarity. We describe two cases of an ETT occurring in two women, one aged 44 years and the other 42 years.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"7 1","pages":"34 - 36"},"PeriodicalIF":0.3,"publicationDate":"2015-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2015.1030893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psoas abscess: a rare metastatic presentation of asymptomatic carcinoma of the cervix","authors":"Ruquiya Afrose, Mohammad Akram, Saifullah Khalid, S. S. Ahmad, S. Siddiqui","doi":"10.1080/20742835.2015.1030894","DOIUrl":"https://doi.org/10.1080/20742835.2015.1030894","url":null,"abstract":"Abstract Isolated metastasis to the iliopsoas muscle is rare and is often misdiagnosed as psoas abcess, especially when it is the only presenting feature in the absence of a known primary tumour. A 52-year-old woman presented to us with a clinicoradiological diagnosis of psoas abscess. Initially, the patient was managed as a case of tubercular psoas abscess. However, later on, when the disease had not responded to antitubercular therapy, a cytological examination of aspirated material was performed, which confirmed it as being malignant in origin. While searching for primary malignancy, a small growth on the cervix was noticed. A biopsy and histopathological examination confirmed the diagnosis of squamous cell carcinoma of the cervix. A final diagnosis of squamous cell carcinoma of the cervix with isolated iliopsoas muscle metastasis was proposed. This case highlights an unusual site of metastasis in an asymptomatic primary tumour which was diagnosed retrospectively.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"7 1","pages":"37 - 39"},"PeriodicalIF":0.3,"publicationDate":"2015-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2015.1030894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living with the late effects of cervical cancer treatment: a descriptive qualitative study at an academic hospital in Gauteng","authors":"SN Ntinga, J. Maree","doi":"10.1080/20742835.2015.1030890","DOIUrl":"https://doi.org/10.1080/20742835.2015.1030890","url":null,"abstract":"Abstract Objective: The late effects of cervical cancer and its treatment are well known. However, qualitative research describing how women experience these effects seems to be unavailable. The purpose of our study was to describe how women experienced the late effects of cervical cancer treatment. Design: A qualitative descriptive design was used. Subjects and setting: Purposive sampling was employed to select the participants treated at an academic hospital in Gauteng. Sixteen in-depth interviews were conducted. Data saturation determined the sample size. Thematic analysis was used to analyse the data. Results: The average age of the sample was 44.1 years, and half of the participants had stage IIB cancer. Most were treated with external beam radiation in combination with brachytherapy. Five themes arose from the data, namely experiencing the physical consequences of the treatment, struggling with the socio-economic implications of the treatment, living with the sexual consequences of the treatment, spiritual issues relating to cervical cancer and facing health system challenges. Conclusion: The late effects deriving from cervical cancer treatment deprived women of the lives they lived before they were treated for cervical cancer. They were burdened with physical changes which aggravated their already difficult financial situation, and they had to live with unattended healthcare needs. Sexual dysfunction changed their intimate partner relationships, leading to anxiety about the possible loss of their life partners. Despite all this, they were positive about their future owing to their faith. Nurses should assess patients for the late effects of cervical cancer and implement interventions to meet their individual needs.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"7 1","pages":"21 - 26"},"PeriodicalIF":0.3,"publicationDate":"2015-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2015.1030890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological options for the protection of ovarian function in patients undergoing chemotherapy","authors":"M. Botha","doi":"10.1080/20742835.2015.1030888","DOIUrl":"https://doi.org/10.1080/20742835.2015.1030888","url":null,"abstract":"Abstract Chemotherapy, particularly alkylating agents, can be toxic to germ cells, and may lead to treatment amenorrhoea in young women. The age at which chemotherapy is administered is a strong predictor of subsequent premature ovarian failure, with older patients being at the highest risk. Smaller primordial follicles may survive the insult of chemotherapy better, and the suppression of follicle development may protect the germ cell pool. The suppression of follicle development by gonadotrophin-releasing hormone agonists (or antagonists) or combined oral contraceptives has been reported in the literature. The results are promising, but conflicting reports on the protection makes further studies essential.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"7 1","pages":"27 - 33"},"PeriodicalIF":0.3,"publicationDate":"2015-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2015.1030888","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"About this issue…","authors":"G. Dreyer","doi":"10.1080/20742835.2014.11441220","DOIUrl":"https://doi.org/10.1080/20742835.2014.11441220","url":null,"abstract":"","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"6 1","pages":"3 - 4"},"PeriodicalIF":0.3,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2014.11441220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}