Introduction: Pelvic exenteration can cure recurrent gynecological malignancies. However, treatment morbidity is over 50% in radiated pelves. We evaluated the outcome, the morbidity and the quality of life after exent...Introduction: Pelvic exenteration can cure recurrent gynecological malignancies. However, treatment morbidity is over 50% in radiated pelves. We evaluated the outcome, the morbidity and the quality of life after exenteration. Methods: Patients who underwent an exenteration for recurrent cervical or endometrial cancer in our institution between 1999 and 2011 were retrieved. Survival rates were calculated according to Kaplan-Meier method and compared using the logrank test. The EORTC QLQ-C30 and QLQ-CX24 questionnaires were sent to patients alive in January 2012. Results: We identified 25 patients: 17 (68%) had cervical cancer and 8 (32%) endometrial cancer. 92% of them had received radiotherapy previously. All patients had a central pelvic recurrence, within a median time of 30 months [4 - 384] from initial treatment. Early complications requiring a re-laparotomy occurred in 9 patients (36%). Late complications included 2 (8%) fistulas, 2 (8%) occlusion and 1 (4%) ureteral stenosis. Complete resection was obtained in 92% of patients. Disease Free and Overall survival rates were better in cervical rather than in endometrial cancer (median DFS in months 17 [2 - 145] vs 9.5 [3 - 21], p = 0.064, median OS in months 20 [2 - 145] vs 13 [4 - 42], p = 0.019). 69% of patients answered the quality of life questionnaires. Mean global quality of life score was 45 on a scale of 0 - 100, none of the patients had a sexual activity. Conclusions: Morbidity of exenteration remains high and quality of life is altered. Endometrial cancer is associated with a poorer prognosis. In those patients, exenteration should be put in balance with best supportive care.展开更多
Objective: To observe the efficacy and toxicities of paclitaxel plus cisplatin in the treatment of recurrent cervical cancer. Methods: Twenty-three patients with a diagnosis of recurrent cervical cancer were eligible....Objective: To observe the efficacy and toxicities of paclitaxel plus cisplatin in the treatment of recurrent cervical cancer. Methods: Twenty-three patients with a diagnosis of recurrent cervical cancer were eligible. Three-weekly chemo- therapy regimen consisted of paclitaxel 135–150 mg/m2 infusion for 3 h on day 1, cisplatin 25 mg/m2 infusion on day 1 to 3. All patients received at least two cycles treatment. Results: The response rates was 47.8%, including CR 2 cases (8.7%), PR 9 cases (39.1%). The major toxicity included neutropenia, nausea vomiting, arthralgia, myalgia and alopecia. Conclusion: Paclitaxel combined with cisplatin is an effective therapy with acceptable adverse reactions for recurrent cervical cancer.展开更多
OBJECTIVE To evaluate the role of whole-body {^18F} fluro-2- dexoxyglucose (FDG) positron emission tomography (PET) scans in the detection of recurrent cervical cancer. METHODS Between June, 2000 and January, 2006...OBJECTIVE To evaluate the role of whole-body {^18F} fluro-2- dexoxyglucose (FDG) positron emission tomography (PET) scans in the detection of recurrent cervical cancer. METHODS Between June, 2000 and January, 2006, 25 patients had undergone a PET scan at the Peking Union Medical College Hospital to evaluate possible recurrent cervical cancer. All the PET findings were reviewed and compared to available clinical data to classify each PET scan result as a true positive, true negative, false positive, or false negative. RESULTS A total of 38 PET scans were conducted on the 25 patients whose median age was 46 years. The Stage distributions were ⅠA (n = 1), ⅠB (n = 11), ⅡA (n =5), ⅡB (n = 4), ⅢB (n = 2),ⅣB (n = 1), and unknown Stage (n = 1). There were 22 cases of squamous cell carcinoma and 3 cases of adenocarcinoma resulting in 9 true positive PET scans, 27 true negatives, 2 false positives and no false negatives. The sensitivity of the FDG PET scans for detecting recurrent cervical cancer was 100%, specificity 93.1%, positive predictive value 81.8%, and negative predictive value 100%. CONCLUSION The whole body FDG PET scans are a sensitive and specific imaging modality for the detection of recurrent cervical cancer. However the cost of PET scans is too high at this time. A large prospective study will determine whether this modality should be used routinely and take the place of other imaging methods in the early detection of recurrent cervical carcinoma.展开更多
For patients with primary stage IVB, persistent, or recurrent cervical cancer, chemotherapy remains the standard treatment, although it is neither curative nor associated with long-term disease control. In this review...For patients with primary stage IVB, persistent, or recurrent cervical cancer, chemotherapy remains the standard treatment, although it is neither curative nor associated with long-term disease control. In this review, we summarized the history of treatment of recurrent cervical cancer, and the current recommendation for chemotherapy and molecular targeted therapy. Eligible articles were identified by a search of the MEDLINE bibliographical database for the period up to November 30, 2014. The search strategy included the following any or all of the keywords: "uterine cervical cancer", "chemotherapy", and "targeted therapies". Since cisplatin every 21 days was considered as the historical standard treatment for recurrent cervical cancer, subsequent trials have evaluated and demonstrated activity for other agents including paclitaxel, gemcitabine, topotecan and vinorelbine among others. Accordingly, promising agents were incorporated into phase III trials. To examine the best agent to combine with cisplatin, several landmark phase III clinical trials were conducted by Gynecologic Oncology Group (GOG) and Japan Clinical Oncology Group (JCOG). Through, GOG204 and JCOG0505, paclitaxel/cisplatin (TP) and paclitaxel/carboplatin (TC) are now considered to be the recommended therapies for recurrent cervical cancer patients. However, the prognosis of patients who are already resistant to chemotherapy, are very poor. Therefore new therapeutic strategies are urgently required. Molecular targeted therapy will be the most hopeful candidate of these strategies. From the results of GOG240, bevacizumab combined with TP reached its primary endpoint of improving overall survival (OS). Although, the prognosis for recurrent cervical cancer patients is still poor, the results of GOG240 shed light on the usefulness of molecular target agents to chemotherapy in cancer patients. Recurrent cervical cancer is generally considered incurable and current chemotherapy regiments offer only modest gains in OS, particularly for patients with multiple poor prognostic factors. Therefore, it is crucial to consider not only the survival benefit, but also the minimization of treatment toxicity, and maximization of quality of life (QOL).展开更多
Objective:To investigate the effect of concurrent chemoradiotherapy on the survival rate and safety of patients with recurrent cervical cancer.Methods:A total of 107 patients with recurrent cervical cancer who were tr...Objective:To investigate the effect of concurrent chemoradiotherapy on the survival rate and safety of patients with recurrent cervical cancer.Methods:A total of 107 patients with recurrent cervical cancer who were treated in our hospital from March 2016 to January 2019 were retrospectively analyzed and randomly divided into the control group(n=53)and the observation group(n=54)and treated conventionally.On this basis,the control group was treated with radiotherapy,and the observation group was treated with concurrent radiotherapy and chemotherapy.The clinical efficacy,cellular immune index,survival rate and rate of adverse reactions were compared between the two groups.Results:Compared with the total effective rate of 79.25%in the control group,the observation group was 94.44%,and the difference was statistically significant(P<0.05).After treatment,the levels of NK,CD3+,and CD4+in the two groups were higher than before the treatment,and the observation group was higher than the control group.The difference was statistically significant(P<0.05).Compared with the adverse reaction rate of 18.87%in the control group,the observation group was 11.11%,but the difference was not statistically significant(P>0.05).Conclusion:Concurrent chemoradiotherapy for patients with recurrent cervical cancer has a significant effect,which not only can effectively improve the cellular immune index and the survival rate of patients,but also have high safety.展开更多
Risk modeling for recurrent cervical cancer requires the development of new concepts and methodologies. Unlike most daily decisions, many medical decision making have substantial consequences, and involve important un...Risk modeling for recurrent cervical cancer requires the development of new concepts and methodologies. Unlike most daily decisions, many medical decision making have substantial consequences, and involve important uncertainties and trade-offs. The uncertainties may be about the accuracy of available diagnostic tests, the natural history of the cervical cancer, the effects of treatment in a patient or the effects of an intervention in a group or population as a whole. With such complex decisions, it can be difficult to comprehend all options “in our heads”. This study applied Bayesian decision analysis to an inferential problem of recurrent cervical cancer in survival analysis. A formulation is considered where individual was expected to experience repeated events, along with concomitant variables. In addition, the sampling distribution of the observations is modelled through a proportional intensity Nonhomogeneous Poisson process. The proposed decision models can provide decision support techniques not only for taking action in the light of all available relevant information, but also for minimizing expected loss. The decision process is useful in selecting the best alternative when a patient with recurrent cervical cancer, in particular, the proposed decision process can provide more realistic solutions.展开更多
Objective: The aim of the study was to explore the efficacy of three-dimensional conformal radiotherapy (3D- CRT) combined with TP concurrent chemotherapy in treatment of recurrent cervical cancers. Methods: From ...Objective: The aim of the study was to explore the efficacy of three-dimensional conformal radiotherapy (3D- CRT) combined with TP concurrent chemotherapy in treatment of recurrent cervical cancers. Methods: From May 2005 to May 2009, 36 patients with recurrent cervical cancer were treated by 3D-CRT of 60-66 Gy and TP (docetaxel 70 mg/m^2, d1; cisplatin 20 mg/m^2, dl-d3; 21 days per cycle, totally 2 cycles) concurrent chemotherapy. Results: All of the patients had finished the 3D-CRT, the total response rate, complete response rate and partial response rate were 80.0% (28/35), 45.7% (16/35), and 34.3% (12/35), respectively. The pain-alleviation rate was 91.4% (32/35). The hemorrhage control rate was 94.3% (33/35). The median overall survival was 21.2 months. The 1-, 2- and 3-year survival rates were 54.3%, 37.1% and 22.8%, respectively. The life qualities of the patients were improved, without any treatment related death. Conclusion: Radiotherapy is effective and well-tolerated for recurrent cervical cancers, and it can promote regional control of the disease and prolong survival time.展开更多
Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introdu...Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.展开更多
Objective: Cervical cancer represents the third most commonly diagnosed cancer and is an important cause of death for women suffering with malignancies. Patients who are refractory or progressed after first-line palli...Objective: Cervical cancer represents the third most commonly diagnosed cancer and is an important cause of death for women suffering with malignancies. Patients who are refractory or progressed after first-line palliative treatment have a dismal prognosis and no second-line chemotherapy is considered standard so far. Several agents have been investigated in this setting and topotecan is one of the most characterized. The objective of this study was to evaluate response rate (RR), progression-free survival (PFS), overall survival (OS) and toxicity of topotecan in second palliative line for cervical cancer. Methods: An analysis was performed of all patients with recurrent or metastatic cervical cancer treated with topotecan in second palliative line at Brazilian National Cancer Institute, between 2008 and 2010. Results: A total of 73 courses of topotecan were given in the current study (median: 3.5 cycles;range 1 - 6). Anemia was the most frequent adverse event (grade 2:35%;grade 3:30%). Of the 20 patients evaluable, there were 2 partial responders to the treatment. The overall response rate (ORR) was 10%;3 patients (15%) had stable disease as maximum response. The median PFS for the entire group was 2.93 months (95% CI 2.41 - 3.45) and OS was 4.66 months (95% CI 1.21 - 8.11). Conclusion: The limited activity of topotecan schemas in second-line treatment of cervical cancer and the associated overall toxicity may not justify their use in this setting. Patients who progress after first-line treatment may be offered participation in clinical trials, other second-line agents or best supportive care measures.展开更多
Cervical cancer is an intrusive cancer that imitates various women around the world. Cervical cancer ranks in thefourth position because of the leading death cause in its premature stages. The cervix which is the lowe...Cervical cancer is an intrusive cancer that imitates various women around the world. Cervical cancer ranks in thefourth position because of the leading death cause in its premature stages. The cervix which is the lower end of thevagina that connects the uterus and vagina forms a cancerous tumor very slowly. This pre-mature cancerous tumorin the cervix is deadly if it cannot be detected in the early stages. So, in this delineated study, the proposed approachuses federated machine learning with numerous machine learning solvers for the prediction of cervical cancer totrain the weights with varying neurons empowered fuzzed techniques to align the neurons, Internet of MedicalThings (IoMT) to fetch data and blockchain technology for data privacy and models protection from hazardousattacks. The proposed approach achieves the highest cervical cancer prediction accuracy of 99.26% and a 0.74%misprediction rate. So, the proposed approach shows the best prediction results of cervical cancer in its early stageswith the help of patient clinical records, and all medical professionals will get beneficial diagnosing approachesfrom this study and detect cervical cancer in its early stages which reduce the overall death ratio of women due tocervical cancer.展开更多
BACKGROUND Para-aortic lymph nodes(PALNs)are common sites for the regional spread of cervical squamous cell carcinoma(SCC).CASE SUMMARY We report the case of a 36-year-old woman who presented with cervical SCC with mu...BACKGROUND Para-aortic lymph nodes(PALNs)are common sites for the regional spread of cervical squamous cell carcinoma(SCC).CASE SUMMARY We report the case of a 36-year-old woman who presented with cervical SCC with multiple bulky PALNs,largest measured 4.5 cm×5 cm×10 cm.The patient was treated with radical intent with definitive chemoradiation using sequential doseescalated adaptive radiotherapy,followed by maintenance chemotherapy.The patient achieved a complete response;she has been doing well since the completion of treatment with no evidence of the disease for 2 years.CONCLUSION Regardless of the size of PALN metastases of cervical carcinoma origin,it is still treatable(with radical intent)via concurrent chemoradiation.Adaptive radiotherapy allows dose escalation with minimal toxicity.展开更多
At present,the role of many long non-coding RNAs(lncRNAs)as tumor suppressors in the formation and development of cervical cancer(CC)has been studied.However,lncRNA prostate cancer gene expression marker 1(PCGEM1),who...At present,the role of many long non-coding RNAs(lncRNAs)as tumor suppressors in the formation and development of cervical cancer(CC)has been studied.However,lncRNA prostate cancer gene expression marker 1(PCGEM1),whose high expression not only aggravates ovarian cancer but also can induce tumorigenesis and endometrial cancer progression,has not been studied in CC.The objective of this study was to investigate the expression and the underlying role of PCGEM1 in CC.The relative expression of PCGEM1 in CC cells was detected by real-time PCR.After the suppression of PCGEM1 expression by shRNA,the changes in the proliferation,migration,and invasion capacities were detected via CCK-8 assay,EdU assay,and colony formation assay wound healing assay.Transwell assay and the changes in expressions of epithelial-to-mesenchymal transition(EMT)markers were determined by western blot and immunofluorescence.The interplay among PCGEM1,miR-642a-5p,and kinesin family member 5B(KIF5B)was confirmed by bioinformatics analyses and luciferase reporter assay.Results showed that PCGEM1 expressions were up-regulated within CC cells.Cell viabilities,migration,and invasion were remarkably reduced after the suppression of PCGEM1 expression by shRNA in Hela and SiHa cells.N-cadherin was silenced,but E-cadherin expression was elevated by sh-PCGEM1.Moreover,by sponging miR-642a-5p in CC,PCGEM1 was verified as a competitive endogenous RNA(ceRNA)that modulates KIF5B levels.MiR-642a-5p down-regulation partially rescued sh-PCGEM1’s inhibitory effects on cell proliferation,migration,invasion,and EMT process.In conclusion,the PCGEM1/miR-642a-5p/KIF5B signaling axis might be a novel therapeutic target in CC.This study provides a research basis and new direction for targeted therapy of CC.展开更多
Objective: Evaluate pretreatment sarcopenia and anemia as prognostic factors in women undergoing treatment for cervical cancer (CC) with concurrent chemoradiotherapy (CCRT). Methods: 151 women with CC were analysed in...Objective: Evaluate pretreatment sarcopenia and anemia as prognostic factors in women undergoing treatment for cervical cancer (CC) with concurrent chemoradiotherapy (CCRT). Methods: 151 women with CC were analysed in this cohort study. Pretreatment computed tomography (CT) images were analysed to assess skeletal muscle index (SMI). Hazard ratios (HR) and multivariate Cox proportional HR were used to analyse association between low SMI, age, body mass index (BMI), haemoglobin levels, histological type, and International Federation of Gynaecology and Obstetrics (FIGO) stage with PFS and OS. Results: A total of 151 patients were included, 53 (35.1%) presented pretreatment sarcopenia;51 (34%) stage I/II and 100 (66%) stage III/IV. Among those patients in advanced stage (III/IV) 37 (70%) (p = 0.28) were sarcopenic at the beginning of treatment. Sarcopenia was associated with worse progression-free survival (PFS) and overall survival (OS) in our cohort [HR 0.97 (p = 0.01)] [HR 0.73 (p = 0.001)], as well as anemia [HR 0.73 (p = 0.001)] [HR 0.78 (p = 0.001)]. Linear regression models indicated that despite showing no association with age, neutrophil or platelet counts, sarcopenia was associated with pretreatment anemia levels (p = 0.01). After a multivariate analysis, only haemoglobin (anemia) and complete CCRT remained associated with PFS and OS. Sarcopenia and anemia were associated with worse PFS and OS in FIGO stage I/II. Conclusion: Pretreatment sarcopenia was significantly associated with low haemoglobin levels. Anemia and incomplete CCRT were independently associated with poor prognosis in women with CC. Pretreatment sarcopenia, as low SMI, was a predictor of poor prognostic in early stages of CC.展开更多
Objective: To investigate the status quo of stigma and marital satisfaction of patients with cervical cancer, and analyze the correlation between them, to provide a reference for making intervention plans for patients...Objective: To investigate the status quo of stigma and marital satisfaction of patients with cervical cancer, and analyze the correlation between them, to provide a reference for making intervention plans for patients with cervical cancer. Methods: 216 patients in a third-class first-class hospital in Zhengzhou were investigated by convenient sampling method, using a general information questionnaire, social impact scale, and Olson marriage quality questionnaire. Results: The total stigma score of cervical cancer patients was 73.00 (62.00, 76.00), which was high. The total marital satisfaction score is 36.00 (26.00, 38.00), in the middle level. There was a negative correlation between marital satisfaction and stigma (P Conclusion: The stigma of patients with cervical cancer is at a high level, and their marital satisfaction is at a medium level. Medical staff should give them health education through various channels, pay attention to low-income patients, improve marital satisfaction, and reduce stigma.展开更多
Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment mo...Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screening and awareness of early symptoms can reverse the situation.展开更多
Objective: To explore the status quo of acceptance of illness among reproductive-age cervical cancer patients and its influencing factors, to provide a theoretical basis for the implementation of targeted intervention...Objective: To explore the status quo of acceptance of illness among reproductive-age cervical cancer patients and its influencing factors, to provide a theoretical basis for the implementation of targeted interventions. Methods: The convenience sampling method was used to investigate 256 reproductive-age cervical cancer patients using the general information questionnaire, Acceptance of Illness Scale, Reproductive Concerns After Cancer Scale, and Medical Coping Style Scale. Results: The total score of the acceptance of illness was (18.03 ± 3.24), and reproductive concerns were (57.02 ± 6.30), among reproductive-age cervical cancer patients. Multivariate analysis showed that age, number of children, income level, treatment method, level of reproductive concerns, and the yield and avoidance dimensions of medical coping style were the main influencing factors on patients’ level of illness acceptance (all P Conclusion: The acceptance of illness levels in reproductive-age cervical cancer patients was low to intermediate, and medical staff should timely identify high-risk groups and take preventive management measures based on influencing factors.展开更多
Background: Cervical cancer is a significant health concern in Bangladesh, with high mortality rates due to limited awareness and costly treatments. The disease stages influence treatment protocols, ranging from surge...Background: Cervical cancer is a significant health concern in Bangladesh, with high mortality rates due to limited awareness and costly treatments. The disease stages influence treatment protocols, ranging from surgery and radiotherapy for early stages to chemotherapy and radiation for advanced stages, but survival rates decrease as the cancer progresses. Objective: The objective of this study is to determine the economic impact of the disease and recommend cost-efficient strategies for prevention and treatment. Methods: A population-based, cross-sectional study was conducted with a stratified sample of cervical cancer patients from selected healthcare facilities across Bangladesh. Data collection involved structured interviews and validated questionnaires. The study measured the economic impact, treatment costs, and other related expenses. Quantitative data analysis was performed using SPSS v22, MS-Excel, and R Programming, with Multivariate regression analysis and Post Hoc tests, including the chi-square test, applied to selected indicators. Results: All respondents in the study were female, aged 34 - 75, with 72.3% aged 40 - 50. Most were illiterate (38.6%) and housewives (95.0%). Additionally, 98% were married, 85.10% married before age 18, and 46.50% experienced their first menstruation before age 12. Families typically had a monthly income of 10,000 - 30,000 Taka, spending similar amounts on treatment. Significant relationships were found between educational qualifications, occupation, personal hygiene practices, history of oral contraceptive use, and age of marriage (p Conclusion: The article emphasizes the impact of monthly family income on cervical cancer treatment costs, stressing the need for comprehensive support services to address the financial and emotional burdens faced by patients. Improving access to quality care and implementing measures can enhance outcomes for cervical cancer patients in Bangladesh.展开更多
BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its effic...BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.展开更多
Cervical cancer is a serious threat to women’s health.Persistent high-risk human papillomavirus(HPV)infection is a necessary factor for cervical cancer development and has become a serious public health threat to wom...Cervical cancer is a serious threat to women’s health.Persistent high-risk human papillomavirus(HPV)infection is a necessary factor for cervical cancer development and has become a serious public health threat to women.At present,young women have become a high-risk group for potential HPV infection.HPV vaccination is an effective method to prevent HPV infection and related diseases and is a primary preventive measure for HPV infection-related diseases.This study explores the influencing factors of female college students’willingness to receive HPV vaccination,their ability to understand college students’HPV awareness,their motivation for HPV vaccination,their behavioral skills related to HPV vaccination,their willingness to receive HPV vaccination and their vaccination rate.The aim of this study was to increase the HPV vaccination rate of Chinese female college students through health education programs and thus reduce the incidence of cervical cancer.展开更多
Introduction: The relationship between knowledge of HPV and vaccination has been established. The aim of this study was to investigate the knowledge of mothers or guardians of girls aged 9 - 14 about cervical cancer a...Introduction: The relationship between knowledge of HPV and vaccination has been established. The aim of this study was to investigate the knowledge of mothers or guardians of girls aged 9 - 14 about cervical cancer and their attitudes to HPV vaccination. Methodology: This was a descriptive cross-sectional survey. The sample size was calculated using the Schwartz formula and distributed proportionally to the size of the neighbourhood population. Data was collected between 2nd to 19th January 2024 using anonymous questionnaires configured on tablets with Survey 123 software and analysed using R software. Results: A total of 799 people were interviewed. The average age of the respondents was 35.67 years, with a standard deviation of 7.08 and a range of 17 and 49 years. The information channels for cervical cancer were the media (82.8%), health facilities (47.7%) and community intermediaries (23.3%). Only 53.7% had information about the vaccine and 25.5% about the vaccination strategy. The main reason for accepting the vaccine was awareness of the seriousness of cervical cancer (55.1%). Conclusion: It is essential to take stock of knowledge about cervical cancer and attitudes to vaccination to assess the impact of interventions and redirect strategies to improve vaccination coverage. .展开更多
文摘Introduction: Pelvic exenteration can cure recurrent gynecological malignancies. However, treatment morbidity is over 50% in radiated pelves. We evaluated the outcome, the morbidity and the quality of life after exenteration. Methods: Patients who underwent an exenteration for recurrent cervical or endometrial cancer in our institution between 1999 and 2011 were retrieved. Survival rates were calculated according to Kaplan-Meier method and compared using the logrank test. The EORTC QLQ-C30 and QLQ-CX24 questionnaires were sent to patients alive in January 2012. Results: We identified 25 patients: 17 (68%) had cervical cancer and 8 (32%) endometrial cancer. 92% of them had received radiotherapy previously. All patients had a central pelvic recurrence, within a median time of 30 months [4 - 384] from initial treatment. Early complications requiring a re-laparotomy occurred in 9 patients (36%). Late complications included 2 (8%) fistulas, 2 (8%) occlusion and 1 (4%) ureteral stenosis. Complete resection was obtained in 92% of patients. Disease Free and Overall survival rates were better in cervical rather than in endometrial cancer (median DFS in months 17 [2 - 145] vs 9.5 [3 - 21], p = 0.064, median OS in months 20 [2 - 145] vs 13 [4 - 42], p = 0.019). 69% of patients answered the quality of life questionnaires. Mean global quality of life score was 45 on a scale of 0 - 100, none of the patients had a sexual activity. Conclusions: Morbidity of exenteration remains high and quality of life is altered. Endometrial cancer is associated with a poorer prognosis. In those patients, exenteration should be put in balance with best supportive care.
文摘Objective: To observe the efficacy and toxicities of paclitaxel plus cisplatin in the treatment of recurrent cervical cancer. Methods: Twenty-three patients with a diagnosis of recurrent cervical cancer were eligible. Three-weekly chemo- therapy regimen consisted of paclitaxel 135–150 mg/m2 infusion for 3 h on day 1, cisplatin 25 mg/m2 infusion on day 1 to 3. All patients received at least two cycles treatment. Results: The response rates was 47.8%, including CR 2 cases (8.7%), PR 9 cases (39.1%). The major toxicity included neutropenia, nausea vomiting, arthralgia, myalgia and alopecia. Conclusion: Paclitaxel combined with cisplatin is an effective therapy with acceptable adverse reactions for recurrent cervical cancer.
文摘OBJECTIVE To evaluate the role of whole-body {^18F} fluro-2- dexoxyglucose (FDG) positron emission tomography (PET) scans in the detection of recurrent cervical cancer. METHODS Between June, 2000 and January, 2006, 25 patients had undergone a PET scan at the Peking Union Medical College Hospital to evaluate possible recurrent cervical cancer. All the PET findings were reviewed and compared to available clinical data to classify each PET scan result as a true positive, true negative, false positive, or false negative. RESULTS A total of 38 PET scans were conducted on the 25 patients whose median age was 46 years. The Stage distributions were ⅠA (n = 1), ⅠB (n = 11), ⅡA (n =5), ⅡB (n = 4), ⅢB (n = 2),ⅣB (n = 1), and unknown Stage (n = 1). There were 22 cases of squamous cell carcinoma and 3 cases of adenocarcinoma resulting in 9 true positive PET scans, 27 true negatives, 2 false positives and no false negatives. The sensitivity of the FDG PET scans for detecting recurrent cervical cancer was 100%, specificity 93.1%, positive predictive value 81.8%, and negative predictive value 100%. CONCLUSION The whole body FDG PET scans are a sensitive and specific imaging modality for the detection of recurrent cervical cancer. However the cost of PET scans is too high at this time. A large prospective study will determine whether this modality should be used routinely and take the place of other imaging methods in the early detection of recurrent cervical carcinoma.
文摘For patients with primary stage IVB, persistent, or recurrent cervical cancer, chemotherapy remains the standard treatment, although it is neither curative nor associated with long-term disease control. In this review, we summarized the history of treatment of recurrent cervical cancer, and the current recommendation for chemotherapy and molecular targeted therapy. Eligible articles were identified by a search of the MEDLINE bibliographical database for the period up to November 30, 2014. The search strategy included the following any or all of the keywords: "uterine cervical cancer", "chemotherapy", and "targeted therapies". Since cisplatin every 21 days was considered as the historical standard treatment for recurrent cervical cancer, subsequent trials have evaluated and demonstrated activity for other agents including paclitaxel, gemcitabine, topotecan and vinorelbine among others. Accordingly, promising agents were incorporated into phase III trials. To examine the best agent to combine with cisplatin, several landmark phase III clinical trials were conducted by Gynecologic Oncology Group (GOG) and Japan Clinical Oncology Group (JCOG). Through, GOG204 and JCOG0505, paclitaxel/cisplatin (TP) and paclitaxel/carboplatin (TC) are now considered to be the recommended therapies for recurrent cervical cancer patients. However, the prognosis of patients who are already resistant to chemotherapy, are very poor. Therefore new therapeutic strategies are urgently required. Molecular targeted therapy will be the most hopeful candidate of these strategies. From the results of GOG240, bevacizumab combined with TP reached its primary endpoint of improving overall survival (OS). Although, the prognosis for recurrent cervical cancer patients is still poor, the results of GOG240 shed light on the usefulness of molecular target agents to chemotherapy in cancer patients. Recurrent cervical cancer is generally considered incurable and current chemotherapy regiments offer only modest gains in OS, particularly for patients with multiple poor prognostic factors. Therefore, it is crucial to consider not only the survival benefit, but also the minimization of treatment toxicity, and maximization of quality of life (QOL).
文摘Objective:To investigate the effect of concurrent chemoradiotherapy on the survival rate and safety of patients with recurrent cervical cancer.Methods:A total of 107 patients with recurrent cervical cancer who were treated in our hospital from March 2016 to January 2019 were retrospectively analyzed and randomly divided into the control group(n=53)and the observation group(n=54)and treated conventionally.On this basis,the control group was treated with radiotherapy,and the observation group was treated with concurrent radiotherapy and chemotherapy.The clinical efficacy,cellular immune index,survival rate and rate of adverse reactions were compared between the two groups.Results:Compared with the total effective rate of 79.25%in the control group,the observation group was 94.44%,and the difference was statistically significant(P<0.05).After treatment,the levels of NK,CD3+,and CD4+in the two groups were higher than before the treatment,and the observation group was higher than the control group.The difference was statistically significant(P<0.05).Compared with the adverse reaction rate of 18.87%in the control group,the observation group was 11.11%,but the difference was not statistically significant(P>0.05).Conclusion:Concurrent chemoradiotherapy for patients with recurrent cervical cancer has a significant effect,which not only can effectively improve the cellular immune index and the survival rate of patients,but also have high safety.
文摘Risk modeling for recurrent cervical cancer requires the development of new concepts and methodologies. Unlike most daily decisions, many medical decision making have substantial consequences, and involve important uncertainties and trade-offs. The uncertainties may be about the accuracy of available diagnostic tests, the natural history of the cervical cancer, the effects of treatment in a patient or the effects of an intervention in a group or population as a whole. With such complex decisions, it can be difficult to comprehend all options “in our heads”. This study applied Bayesian decision analysis to an inferential problem of recurrent cervical cancer in survival analysis. A formulation is considered where individual was expected to experience repeated events, along with concomitant variables. In addition, the sampling distribution of the observations is modelled through a proportional intensity Nonhomogeneous Poisson process. The proposed decision models can provide decision support techniques not only for taking action in the light of all available relevant information, but also for minimizing expected loss. The decision process is useful in selecting the best alternative when a patient with recurrent cervical cancer, in particular, the proposed decision process can provide more realistic solutions.
文摘Objective: The aim of the study was to explore the efficacy of three-dimensional conformal radiotherapy (3D- CRT) combined with TP concurrent chemotherapy in treatment of recurrent cervical cancers. Methods: From May 2005 to May 2009, 36 patients with recurrent cervical cancer were treated by 3D-CRT of 60-66 Gy and TP (docetaxel 70 mg/m^2, d1; cisplatin 20 mg/m^2, dl-d3; 21 days per cycle, totally 2 cycles) concurrent chemotherapy. Results: All of the patients had finished the 3D-CRT, the total response rate, complete response rate and partial response rate were 80.0% (28/35), 45.7% (16/35), and 34.3% (12/35), respectively. The pain-alleviation rate was 91.4% (32/35). The hemorrhage control rate was 94.3% (33/35). The median overall survival was 21.2 months. The 1-, 2- and 3-year survival rates were 54.3%, 37.1% and 22.8%, respectively. The life qualities of the patients were improved, without any treatment related death. Conclusion: Radiotherapy is effective and well-tolerated for recurrent cervical cancers, and it can promote regional control of the disease and prolong survival time.
文摘Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.
文摘Objective: Cervical cancer represents the third most commonly diagnosed cancer and is an important cause of death for women suffering with malignancies. Patients who are refractory or progressed after first-line palliative treatment have a dismal prognosis and no second-line chemotherapy is considered standard so far. Several agents have been investigated in this setting and topotecan is one of the most characterized. The objective of this study was to evaluate response rate (RR), progression-free survival (PFS), overall survival (OS) and toxicity of topotecan in second palliative line for cervical cancer. Methods: An analysis was performed of all patients with recurrent or metastatic cervical cancer treated with topotecan in second palliative line at Brazilian National Cancer Institute, between 2008 and 2010. Results: A total of 73 courses of topotecan were given in the current study (median: 3.5 cycles;range 1 - 6). Anemia was the most frequent adverse event (grade 2:35%;grade 3:30%). Of the 20 patients evaluable, there were 2 partial responders to the treatment. The overall response rate (ORR) was 10%;3 patients (15%) had stable disease as maximum response. The median PFS for the entire group was 2.93 months (95% CI 2.41 - 3.45) and OS was 4.66 months (95% CI 1.21 - 8.11). Conclusion: The limited activity of topotecan schemas in second-line treatment of cervical cancer and the associated overall toxicity may not justify their use in this setting. Patients who progress after first-line treatment may be offered participation in clinical trials, other second-line agents or best supportive care measures.
文摘Cervical cancer is an intrusive cancer that imitates various women around the world. Cervical cancer ranks in thefourth position because of the leading death cause in its premature stages. The cervix which is the lower end of thevagina that connects the uterus and vagina forms a cancerous tumor very slowly. This pre-mature cancerous tumorin the cervix is deadly if it cannot be detected in the early stages. So, in this delineated study, the proposed approachuses federated machine learning with numerous machine learning solvers for the prediction of cervical cancer totrain the weights with varying neurons empowered fuzzed techniques to align the neurons, Internet of MedicalThings (IoMT) to fetch data and blockchain technology for data privacy and models protection from hazardousattacks. The proposed approach achieves the highest cervical cancer prediction accuracy of 99.26% and a 0.74%misprediction rate. So, the proposed approach shows the best prediction results of cervical cancer in its early stageswith the help of patient clinical records, and all medical professionals will get beneficial diagnosing approachesfrom this study and detect cervical cancer in its early stages which reduce the overall death ratio of women due tocervical cancer.
文摘BACKGROUND Para-aortic lymph nodes(PALNs)are common sites for the regional spread of cervical squamous cell carcinoma(SCC).CASE SUMMARY We report the case of a 36-year-old woman who presented with cervical SCC with multiple bulky PALNs,largest measured 4.5 cm×5 cm×10 cm.The patient was treated with radical intent with definitive chemoradiation using sequential doseescalated adaptive radiotherapy,followed by maintenance chemotherapy.The patient achieved a complete response;she has been doing well since the completion of treatment with no evidence of the disease for 2 years.CONCLUSION Regardless of the size of PALN metastases of cervical carcinoma origin,it is still treatable(with radical intent)via concurrent chemoradiation.Adaptive radiotherapy allows dose escalation with minimal toxicity.
基金the Nantong Municipal Health Commission Research Project(MB2021054)for this study.
文摘At present,the role of many long non-coding RNAs(lncRNAs)as tumor suppressors in the formation and development of cervical cancer(CC)has been studied.However,lncRNA prostate cancer gene expression marker 1(PCGEM1),whose high expression not only aggravates ovarian cancer but also can induce tumorigenesis and endometrial cancer progression,has not been studied in CC.The objective of this study was to investigate the expression and the underlying role of PCGEM1 in CC.The relative expression of PCGEM1 in CC cells was detected by real-time PCR.After the suppression of PCGEM1 expression by shRNA,the changes in the proliferation,migration,and invasion capacities were detected via CCK-8 assay,EdU assay,and colony formation assay wound healing assay.Transwell assay and the changes in expressions of epithelial-to-mesenchymal transition(EMT)markers were determined by western blot and immunofluorescence.The interplay among PCGEM1,miR-642a-5p,and kinesin family member 5B(KIF5B)was confirmed by bioinformatics analyses and luciferase reporter assay.Results showed that PCGEM1 expressions were up-regulated within CC cells.Cell viabilities,migration,and invasion were remarkably reduced after the suppression of PCGEM1 expression by shRNA in Hela and SiHa cells.N-cadherin was silenced,but E-cadherin expression was elevated by sh-PCGEM1.Moreover,by sponging miR-642a-5p in CC,PCGEM1 was verified as a competitive endogenous RNA(ceRNA)that modulates KIF5B levels.MiR-642a-5p down-regulation partially rescued sh-PCGEM1’s inhibitory effects on cell proliferation,migration,invasion,and EMT process.In conclusion,the PCGEM1/miR-642a-5p/KIF5B signaling axis might be a novel therapeutic target in CC.This study provides a research basis and new direction for targeted therapy of CC.
文摘Objective: Evaluate pretreatment sarcopenia and anemia as prognostic factors in women undergoing treatment for cervical cancer (CC) with concurrent chemoradiotherapy (CCRT). Methods: 151 women with CC were analysed in this cohort study. Pretreatment computed tomography (CT) images were analysed to assess skeletal muscle index (SMI). Hazard ratios (HR) and multivariate Cox proportional HR were used to analyse association between low SMI, age, body mass index (BMI), haemoglobin levels, histological type, and International Federation of Gynaecology and Obstetrics (FIGO) stage with PFS and OS. Results: A total of 151 patients were included, 53 (35.1%) presented pretreatment sarcopenia;51 (34%) stage I/II and 100 (66%) stage III/IV. Among those patients in advanced stage (III/IV) 37 (70%) (p = 0.28) were sarcopenic at the beginning of treatment. Sarcopenia was associated with worse progression-free survival (PFS) and overall survival (OS) in our cohort [HR 0.97 (p = 0.01)] [HR 0.73 (p = 0.001)], as well as anemia [HR 0.73 (p = 0.001)] [HR 0.78 (p = 0.001)]. Linear regression models indicated that despite showing no association with age, neutrophil or platelet counts, sarcopenia was associated with pretreatment anemia levels (p = 0.01). After a multivariate analysis, only haemoglobin (anemia) and complete CCRT remained associated with PFS and OS. Sarcopenia and anemia were associated with worse PFS and OS in FIGO stage I/II. Conclusion: Pretreatment sarcopenia was significantly associated with low haemoglobin levels. Anemia and incomplete CCRT were independently associated with poor prognosis in women with CC. Pretreatment sarcopenia, as low SMI, was a predictor of poor prognostic in early stages of CC.
文摘Objective: To investigate the status quo of stigma and marital satisfaction of patients with cervical cancer, and analyze the correlation between them, to provide a reference for making intervention plans for patients with cervical cancer. Methods: 216 patients in a third-class first-class hospital in Zhengzhou were investigated by convenient sampling method, using a general information questionnaire, social impact scale, and Olson marriage quality questionnaire. Results: The total stigma score of cervical cancer patients was 73.00 (62.00, 76.00), which was high. The total marital satisfaction score is 36.00 (26.00, 38.00), in the middle level. There was a negative correlation between marital satisfaction and stigma (P Conclusion: The stigma of patients with cervical cancer is at a high level, and their marital satisfaction is at a medium level. Medical staff should give them health education through various channels, pay attention to low-income patients, improve marital satisfaction, and reduce stigma.
文摘Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screening and awareness of early symptoms can reverse the situation.
文摘Objective: To explore the status quo of acceptance of illness among reproductive-age cervical cancer patients and its influencing factors, to provide a theoretical basis for the implementation of targeted interventions. Methods: The convenience sampling method was used to investigate 256 reproductive-age cervical cancer patients using the general information questionnaire, Acceptance of Illness Scale, Reproductive Concerns After Cancer Scale, and Medical Coping Style Scale. Results: The total score of the acceptance of illness was (18.03 ± 3.24), and reproductive concerns were (57.02 ± 6.30), among reproductive-age cervical cancer patients. Multivariate analysis showed that age, number of children, income level, treatment method, level of reproductive concerns, and the yield and avoidance dimensions of medical coping style were the main influencing factors on patients’ level of illness acceptance (all P Conclusion: The acceptance of illness levels in reproductive-age cervical cancer patients was low to intermediate, and medical staff should timely identify high-risk groups and take preventive management measures based on influencing factors.
文摘Background: Cervical cancer is a significant health concern in Bangladesh, with high mortality rates due to limited awareness and costly treatments. The disease stages influence treatment protocols, ranging from surgery and radiotherapy for early stages to chemotherapy and radiation for advanced stages, but survival rates decrease as the cancer progresses. Objective: The objective of this study is to determine the economic impact of the disease and recommend cost-efficient strategies for prevention and treatment. Methods: A population-based, cross-sectional study was conducted with a stratified sample of cervical cancer patients from selected healthcare facilities across Bangladesh. Data collection involved structured interviews and validated questionnaires. The study measured the economic impact, treatment costs, and other related expenses. Quantitative data analysis was performed using SPSS v22, MS-Excel, and R Programming, with Multivariate regression analysis and Post Hoc tests, including the chi-square test, applied to selected indicators. Results: All respondents in the study were female, aged 34 - 75, with 72.3% aged 40 - 50. Most were illiterate (38.6%) and housewives (95.0%). Additionally, 98% were married, 85.10% married before age 18, and 46.50% experienced their first menstruation before age 12. Families typically had a monthly income of 10,000 - 30,000 Taka, spending similar amounts on treatment. Significant relationships were found between educational qualifications, occupation, personal hygiene practices, history of oral contraceptive use, and age of marriage (p Conclusion: The article emphasizes the impact of monthly family income on cervical cancer treatment costs, stressing the need for comprehensive support services to address the financial and emotional burdens faced by patients. Improving access to quality care and implementing measures can enhance outcomes for cervical cancer patients in Bangladesh.
文摘BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.
基金supported by Weifang Health Committee Scientific Research Project(wfwsjk-2023-170)Shenzhen Bao‘an District of Medical and Health Research Project(2023JD212)+1 种基金Shenzhen Bao‘an District of Traditional Chinese Medicine Clinical Research Project(2023ZYYLCZX-12)Shenzhen“Medical and Health Three Projects”Project Grant(SZZYSM 202106003).
文摘Cervical cancer is a serious threat to women’s health.Persistent high-risk human papillomavirus(HPV)infection is a necessary factor for cervical cancer development and has become a serious public health threat to women.At present,young women have become a high-risk group for potential HPV infection.HPV vaccination is an effective method to prevent HPV infection and related diseases and is a primary preventive measure for HPV infection-related diseases.This study explores the influencing factors of female college students’willingness to receive HPV vaccination,their ability to understand college students’HPV awareness,their motivation for HPV vaccination,their behavioral skills related to HPV vaccination,their willingness to receive HPV vaccination and their vaccination rate.The aim of this study was to increase the HPV vaccination rate of Chinese female college students through health education programs and thus reduce the incidence of cervical cancer.
文摘Introduction: The relationship between knowledge of HPV and vaccination has been established. The aim of this study was to investigate the knowledge of mothers or guardians of girls aged 9 - 14 about cervical cancer and their attitudes to HPV vaccination. Methodology: This was a descriptive cross-sectional survey. The sample size was calculated using the Schwartz formula and distributed proportionally to the size of the neighbourhood population. Data was collected between 2nd to 19th January 2024 using anonymous questionnaires configured on tablets with Survey 123 software and analysed using R software. Results: A total of 799 people were interviewed. The average age of the respondents was 35.67 years, with a standard deviation of 7.08 and a range of 17 and 49 years. The information channels for cervical cancer were the media (82.8%), health facilities (47.7%) and community intermediaries (23.3%). Only 53.7% had information about the vaccine and 25.5% about the vaccination strategy. The main reason for accepting the vaccine was awareness of the seriousness of cervical cancer (55.1%). Conclusion: It is essential to take stock of knowledge about cervical cancer and attitudes to vaccination to assess the impact of interventions and redirect strategies to improve vaccination coverage. .