Gynecologic oncology
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Gynecologic oncology · Jan 1996
Clinical TrialOvarian tumors in postmenopausal breast cancer patients treated with tamoxifen.
From September 1, 1989, to November 30, 1994, 175 menopausal breast cancer patients treated with tamoxifen were followed at the authors' institutions. During this period. 16 (9.1%) underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, for various indications. Of these, 10 (62.5%) had either uni- or bilateral ovarian tumors. ⋯ The mean duration of tamoxifen treatment was 36.6 +/- 24.9 (range 9-86) months. The rate of 5.7% for ovarian tumors, in this selected group of patients, is four to five times higher than that reported for similar pathologic conditions detected by general screening with ultrasonographic scans among nonselected, asymptomatic, and untreated postmenopausal women. Two possibilities should be considered in the development of ovarian tumors coinciding with tamoxifen treatment; (1) women with breast malignancy are prone to develop benign or malignant ovarian tumors in relation to genetic factors, regardless of tamoxifen treatment; and (2) tamoxifen may stimulate enlargement of such tumors and may even cause them.
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Gynecologic oncology · Oct 1995
Adrenal function following high-dose steroids in ovarian cancer patients.
Steroid doses similar to those used to prevent paclitaxel-associated hypersensitivity reactions and cisplatin-induced nausea have been associated with hypothalamic-pituitary-adrenal (HPA) axis suppression. We assessed HPA function in patients receiving high-dose steroids as part of their chemotherapy regimen for epithelial ovarian cancer. ⋯ Current steroid regimens prescribed with chemotherapy transiently decrease HPA function, but do not appear to inhibit the HPA axis long term. HPA function may be suppressed for approximately 8 days from the commencement of chemotherapy cycles involving DEX. Patients presenting within the first 8 days of a chemotherapy cycle using steroids with symptoms attributable to HPA suppression may benefit from HPA axis testing.
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Gynecologic oncology · Oct 1995
Targeted eradication of ovarian cancer mediated by intracellular expression of anti-erbB-2 single-chain antibody.
Overexpression of the tyrosine kinase receptor erbB-2 is important in the pathogenesis of a variety of neoplasms including ovarian cancer. As a strategy to selectively eradicate erbB-2-overexpressing tumor cells, an anti-erbB-2 single-chain immunoglobin (sFv) gene was constructed to direct expression of intracellular anti-erbB-2 antibody. The purpose of this study is to establish the antitumorigenicity of this strategy in in vitro and in vivo models. ⋯ The ability to selectively "knock out" erbB-2 demonstrates that this strategy can induce a significant antineoplastic effect in ovarian cancer cells overexpressing this growth factor receptor. In addition, the ability to accomplish selective abrogation of erbB-2 expression in animal treatment models and to transfect and eradicate primary ovarian cancer cells justifies further investigation of this novel strategy in ovarian cancer patients.
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Gynecologic oncology · Jun 1995
Case ReportsTreatment-related myelodysplastic syndrome following abdominopelvic radiotherapy for endometrial cancer.
A patient with grade II endometrial adenocarcinoma underwent TAH/BSO. The tumor penetrated 50% of the myometrium. A lesion from the serosa of the sigmoid colon was removed and contained metastatic adenocarcinoma. ⋯ The patient was doing well with no evidence of recurrence 52 months following treatment when she was diagnosed with a myelodysplastic syndrome. Cytogenetic analysis revealed aberrations of chromosomes 5 and 7, which is highly suggestive of a treatment-related process. Myelodysplasia induced by radiotherapy alone is an unusual but recognized event.
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Gynecologic oncology · Apr 1995
Clinical Trial Controlled Clinical TrialTreatment of locally advanced cervical cancer with concurrent radiation and intra-arterial chemotherapy.
The purpose of this study was to determine the maximum tolerated dose (MTD) and feasibility of treatment with sequential intra-arterial FUDR and cisplatin administered with concurrent whole pelvis radiation (XRT) to women with advanced cervical cancer. Sixteen patients with squamous carcinoma of the cervix were prospectively treated in a Phase I study. All tumors were stages IIb, IIIb, or IVa with diameters of > or = 7 cm. ⋯ At this writing, 10 patients had no evidence of disease, 2 were alive with disease, and 4 had died of disease. Median survival has not been reached. This is a well-tolerated regimen with significant activity that warrants further investigation at dose level 4.