Bhandari Virendra, Kausar Mehlam, Naik Ayush, Batra Manika
Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo institute of Medical Science, Indore, MP India ; 401, Samyak Towers, 16/3 Old Palasia, Indore, MP India.
Department of Radiotherapy, Sri Aurobindo institute of Medical Science, Indore, MP India.
J Obstet Gynaecol India. 2016 Oct;66(5):358-62. doi: 10.1007/s13224-015-0692-y. Epub 2015 May 9.
Although the incidence of cancer cervix has reduced in India during the last two decades, still most of the patients presenting in tertiary care centers are in advanced stages.
At this center, we see 6% of cancer cervix cases every year, and most of these cases are in stage III and IVa. All these patients have squamous cell carcinoma and were treated with a combination of external and intracavitary radiotherapy along with concurrent cisplatin given once weekly. Eighty-nine point nine % patients had achieved a complete response.
Local recurrence was seen in 17.9% at a median duration of 10.5 months, and 8.17% developed distant metastasis involving lung, liver, bone, and supraclavicular lymph nodes. Three patients developed metastasis at unusual sites involving breast, paraspinal muscles, and duodenum which are very rarely involved. These patients were treated with chemotherapy using carboplatin and Paclitaxel combination but succumbed within 8-10 months of development of metastasis.
The cause of involvement of these unusual sites is not clear, but it may be hematological spread, and we want to share these reports such that these sites are seen during follow-up of patients of cancer cervix.
尽管在过去二十年中印度宫颈癌的发病率有所下降,但在三级医疗中心就诊的大多数患者仍处于晚期。
在本中心,我们每年诊治6%的宫颈癌病例,其中大多数病例处于III期和IVa期。所有这些患者均为鳞状细胞癌,接受了外照射和腔内放疗联合顺铂同步化疗,顺铂每周给药一次。89.9%的患者获得了完全缓解。
17.9%的患者出现局部复发,中位持续时间为10.5个月,8.17%的患者发生远处转移,累及肺、肝、骨和锁骨上淋巴结。3例患者在不常见部位发生转移,累及乳腺、椎旁肌肉和十二指肠,这些部位很少受累。这些患者接受了卡铂和紫杉醇联合化疗,但在转移发生后8 - 10个月内死亡。
这些不常见部位受累的原因尚不清楚,但可能是血液播散,我们希望分享这些报告,以便在宫颈癌患者的随访中关注这些部位。