医学交流课件：Professor Sharma-final cancer cervix IA chemotherapy.pptVIP

Current Status of Bland Chemo-embolization in advanced Cancer of Cervix- Impact on Clinical Outcomes Survival Rates Carcinoma of Cervix Cervical cancer remains a major threat to women’s health, accounts for 1,50,000 deaths annually worldwide  2nd most common cancer among women, most common female genital cancer in developing countries  75% of deaths from cervical cancer are from developing countries, also occurs at a younger age in this region  Bleeding is a common symptom major cause of morbidity mortality, its management represents a challenge Whereas treatment strategies for Stage 1 2 are effective with reasonable cure rates, outcomes in stage 3 4 are not so good and less well defined There is a need to think beyond the current treatment Treatment of locally advanced Cancer Cervix For nearly 80 years exclusive radiation was considered the standard of care 5-year survival for stages IB2, IIB, IIIB, and IVA are 72.2, 63.7, 41.7, and 16.4%, respectively 5 randomized studies including nearly 2,000 patients demonstrated that survival rate with concomitant chemotherapy (RT/CT) based on Cisplatin was superior to that obtained with radiation alone New Engl J Med?1999 Aug 26;341(9):708 Annual Report on the results of treatment in Gynaecological Cancer. J Epidemiol statist?1998,?3:5-34 Principles of chemo-radiation Three clinical rationales support use of chemotherapy delivered concurrently with radiation  Concomitant chemo-radiotherapy can be used with organ-preserving intent, resulting in improved cosmetic function compared with surgical resection with or without adjuvant treatment. Chemotherapy can act as a radio-sensitizer, improving probability of local control , in some cases, survival, by aiding destruction of radio-resistant clones ( SYNERGESTIC EFFECT) Chemotherapy given as part of concurrent chemo-radiation may act systemically potentially eradicate distant micro metastases (SPATIAL ADDIVITIVY) Nat Clin Pract Oncol?2007;4(2