Cervical cancer studies

There exist no guidelines for the use of FDG PET in patients with cervical cancer. Studies investigating the use of whole-body FDG PET in cervical cancer demonstrated its diagnostic usefidness in lymph node staging... 

Burghardt E, Baltzer J, Tulusan AH, Haas J (1992) Results of surgical treatment of 1028 cervical cancers studied with volumetry. Cancer 70 648-655... 

In more recent times, large doses of vitamin C have been claimed to prevent the common cold, cure infertility, delay the onset of symptoms in acquired immunodeficiency syndrome (AIDS), and inhibit the development of gastric and cervical cancers. None of these claims have been backed by medical evidence, however. In the largest study yet done of the effect of vitamin C on the common cojd, a meta-analysis of more than 100 separate trials covering 40,000 people found no difference in the incidence of colds between those who took supplemental vitamin G regularly and those who did not. When taken during a cold, however, vitamin C does appear to decrease the cold s duration by 8%. 

This case study presents the clinical trials performed for Plavix (an antiplatelet) and Gardasil (a vaccine against cervical cancer). 

Cohort studies have reported excess lung, liver, bilary, and cervical cancer but are limited by small numbers, insufficient follow-up time,... 

Although flaws in these studies of hydroxyurea left their results open to question, the GOG was convinced that the weight of the evidence supported inclusion of hydroxyurea in the control arms of future trials. In the early 1980s, 308 patients with stages IIB-IVA cervical cancer were randomly assigned to receive radiation therapy with concurrent hydroxyurea or radiation therapy with concurrent misonidazole. A preliminary review... 

Citing the success of mitomycin-C in the treatment of anal cancer, a number of investigators have explored the use of this drug, usually in combination with fluorouracil, in patients treated with radiation for cervical and vulvar carcinomas (23-27). Roberts et al. (27) recently reported results of an interim analysis of a randomized trial, conducted in Venezuela, in which women with locally advanced cervical cancer were treated with radiation therapy with or without mitomycin. At the time of this interim analysis (published while the authors were continuing to accrue patients to the study), the authors noted a significant improvement in disease-free survival (p - 0.01) with chemotherapy but no significant difference in overall survival (p = 0.1). 

Other potential radiation sensitizers for cervical cancer are being explored in phase I and II trials. Paclitaxel has been combined with cisplatin in several small phase I studies. Pignata et al. (29) found that 50 mg/m2 per week of paclitaxel could be combined with weekly cisplatin (30 mg/m2) and radiation therapy with acceptable toxicity, although 10 of 18 patients in their study had grade 3-4 hematologic toxicity. Chen etal. (30) also were able to give weekly paclitaxel at a dose of 50 mg/m2 (in this case combined with 50 mg/m2 of cisplatin every three weeks) with tolerable toxicity and minimal delay in planned radiation therapy. In both studies, the dose-limiting side effect appeared to be diarrhea. It should be noted that the total dose of cisplatin delivered in these trials was lower than that used in the most successful prospective trials of cisplatin or cisplatin and fluorouracil (Table 3). 

Muderspach LI, Curtin JP, Roman LD, et al. Carboplatin as a radiation sensitizer in locally advanced cervical cancer a pilot study. Gynecol Oncol 1997 65 336-342. 

Kumar L, Kaushal R, Nandy M, et al. Chemotherapy followed by radiotherapy versus radiotherapy alone in locally advanced cervical cancer A randomized study. Gynecol Oncol 1994 54 307-315. 

The occurrence of malignant tumors in patients taking oral contraceptives has been studied extensively. It is now clear that these compounds reduce the risk of endometrial and ovarian cancer. The lifetime risk of breast cancer in the population as a whole does not seem to be affected by oral contraceptive use. Some studies have shown an increased risk in younger women, and it is possible that tumors that develop in younger women become clinically apparent sooner. The relation of risk of cervical cancer to oral contraceptive use is still controversial. It should be noted that a number of recent studies associate the use of oral contraceptives by women who are infected with human papillomavirus with an increased risk of cervical cancer. 

Seven cohort studies have examined the risk of cancer among populations exposed to dichloromethane. Two studies observed an excess of pancreatic cancer, but the three others which reported on this tumour did not. One study observed an excess of liver and biliary tract cancers among longer-term employees. One study observed an excess of prostate cancer that appeared to increase with level of exposure. One study observed an excess of breast cancer and gynaecological cancers among women with the highest likelihood of exposure and another study observ ed an excess of cervical cancer. With the exception of the prostate cancer excess observed in one study, all the excesses were based on small numbers. No estimates of exposure levels were available for two of the six studies. 

Four cohort studies and one population-based case-control study have examined the risk of cancer among populations exposed to l,2-dibromo-3-chloropropane, among other chemicals. In two of the cohort studies, an excess of lung cancer was observed based on small numbers of cases. In a third cohort study, an excess of liver and biliary tract cancers was found, while in the fourth an excess of cervical cancer and a non-significant excess of melanoma and leukaemia were observed. How ever, in both of the last two studies, it... 

Data from the classic Nurses Health Study, followed up in 1994, reflected no difference in all-cause mortality between women who had ever used oral contraceptives and those who had never used them (7). There was also no increase in mortality associated with duration of use and no relation with time since first use or time since last use. Similarly, in the OFPA (Oxford) study, the overall 20-year mortality risk for oral contraceptive users compared with women using diaphragms or IUCDs was 0.9, suggesting no effect (8). Although the number of deaths from each cause was small, the pattern is consistent with the risks found in other studies. Oral contraceptive users had somewhat higher death rates from ischemic heart disease and cervical cancer, but lower rates of ovarian cancer mortality. Breast cancer mortality was similar for oral contraceptive users and non-users. 

Motexafin lutetium is also in clinical trials, having completed several Phase I and II studies. The completed trials are for the photodynamic treatment of recurrent breast cancer [41,42], light-based treatment of choroidal neovascularization, [43] and the photoangioplastic reduction of atherosclerotic plaque in peripheral [19,44] and coronary arterial disease [20,45], On the basis of these studies, MLu (Antrin Phototherapy) is currently being developed for the treatment of atherosclerotic plaque. Additionally, the National Cancer Institute is testing MLu for the PDT based treatment of prostate [46,47] and cervical cancers. 

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