Skeletal Muscle Metastases from Squamous Cell Carcinoma of the Cervix: Report of Two Cases With Literature Review.

Cervical carcinoma is the second most common female malignancy worldwide. It usually spreads by direct local extension or the lymphatic vessels. Hematogenous dissemination with distant skeletal muscle metastases is a rare phenomenon. We report here 2 patients whose recurrent squamous cell carcinomas of the cervix presented with symptomatic skeletal muscle metastases affecting the muscles of the thoracic wall and forearm, respectively. We also discuss the differential diagnosis and comprehensively review the previously published literature on this rare presentation of cervical carcinoma.

Concurrent chemoradiation for cervical cancer: results of five randomized trials.

BACKGROUND: Cervical cancer is the second most common cancer among women's in Bosnia and Herzegovina. Most of these women's in the time of diagnosis are with advanced disease. In the 1999 NCI issued a clinical alert, recommending that chemo radiation should be implemented as new treatment for these patients. AIM: To determine a survival, loco regional control and toxicity in patients with cervical carcinoma treated in Institute o Oncology from 2000-2006. PATIENTS AND METHODS: This is retrospective study. Data of five hundred and fourteen patients diagnosed as cervical cancer FIGO stage Ib, -IVb and presented in our Institute, were analyzed. We treated 345 with combined chemo radiotherapy, 162 with radiotherapy alone and 7 patients with symptomatic therapy. In the follow up 134 patients were lost, so 373 patients were analyzed for survival, loco regional control and toxicity. Subgroup of 148 patients with advanced disease and grade of tumor unknown and 136 patients with known grade of tumor were compared for time to local progression, time to distant metastasis and time to death. RESULTS: Median age in this group of patients was 52 (27-85). Of 514 patients 492 were treated with curative intentions and 15 got palliative treatment. All treated patients finished their planed therapy. Follow up was from 6-78 months, median 28 months. From 373 patients who were analyzed 65 died, progressions were observed in 77 patients. Acute toxicity G3/G4 experienced 109 patients, and late toxicity G3/G4 8 patients. Patients with advanced disease and unknown grade of tumor cells had significantly shorter time to local progression, distant metastasis and death. CONCLUSION: The combined therapy for cervical cancer is the safe and good tolerated treatment. In the group of patients with advanced disease we observed 81% overall survival, 55.9% disease free survival for median follow up of 28 months. In the group of patients with early disease we observed 90% overall survival, and 78.8% disease free survival for median follow up of 28 months. There were no deaths caused by treatment.

Ex vivo rapamycin generates apoptosis-resistant donor Th2 cells that persist in vivo and prevent hemopoietic stem cell graft rejection.

Because ex vivo rapamycin generates murine Th2 cells that prevent Graft-versus-host disease more potently than control Th2 cells, we hypothesized that rapamycin would generate Th2/Tc2 cells (Th2/Tc2.R cells) that abrogate fully MHC-disparate hemopoietic stem cell rejection more effectively than control Th2/Tc2 cells. In a B6-into-BALB/c graft rejection model, donor Th2/Tc2.R cells were indeed enriched in their capacity to prevent rejection; importantly, highly purified CD4+ Th2.R cells were also highly efficacious for preventing rejection. Rapamycin-generated Th2/Tc2 cells were less likely to die after adoptive transfer, accumulated in vivo at advanced proliferative cycles, and were present in 10-fold higher numbers than control Th2/Tc2 cells. Th2.R cells had a multifaceted, apoptosis-resistant phenotype, including: 1) reduced apoptosis after staurosporine addition, serum starvation, or CD3/CD28 costimulation; 2) reduced activation of caspases 3 and 9; and 3) increased anti-apoptotic Bcl-xL expression and reduced proapoptotic Bim and Bid expression. Using host-versus-graft reactivity as an immune correlate of graft rejection, we found that the in vivo efficacy of Th2/Tc2.R cells 1) did not require Th2/Tc2.R cell expression of IL-4, IL-10, perforin, or Fas ligand; 2) could not be reversed by IL-2, IL-7, or IL-15 posttransplant therapy; and 3) was intact after therapy with Th2.R cells relatively devoid of Foxp3 expression. We conclude that ex vivo rapamycin generates Th2 cells that are resistant to apoptosis, persist in vivo, and effectively prevent rejection by a mechanism that may be distinct from previously described graft-facilitating T cells.

[Comparative parameters of myelotoxicity in patients treated with simultaneous chemotherapy and radiotherapy or only radiotherapy]. / Komparacija parametara mijelotoksiciteta kod bolesnica lijecenih istovremenom hemo i radio terapijom u odnosu na samu radioterapiju.

BACKGROUND: The Modern oncological treatment usually consists of the different kind of the therapies. Improvement of survival and local control of disease could be possible with combined treatments: surgery, radiotherapy, chemotherapy, etc. However if these treatments are given concomitantly one can expect higher toxicity. AIM: Comparation of parameters of miclotoxicity: red blood cell count, white blood cell count, platelets and hemoglobin in patients with advanced cervical carcinoma treated with concomitant chemo-radiotherapy versus radiotherapy alone. PATIENTS AND METHODS: From 1997-1999, we performed prospective, by randomised, study, and 80 patients were divided in two groups: Group A--40 patients treated with concomitant chemo-radiotherapy versus, Group B--40 patients treated with radiotherapy alone. Red blood cell count, white blood cell count, platelets and hemoglobin were evaluated before enrollement, during the theraphy, after 3 and 6 months, according to CTC toxicity criteria. RESULTS: We perform statistical analysis using H2 test, and we found no significant difference in mild nad severe toxicity in red blood cell count, white blood cell count, platelets and hemoglobin among groups.