A retrospective review of 15 years of radical radiotherapy with or without concurrent cisplatin and/or 5-fluorouracil for the treatment of locally advanced cervical cancer.

Radiation therapy is the standard of care treatment for locally advanced cervical cancer in the United States. In 1999 the addition of concomitant chemotherapy to radical radiotherapy became standard. The addition of cisplatin (CDDP) with or without 5-fluorouracil (5-FU) chemotherapy to radiation therapy was based on the near simultaneous reporting of five randomized, controlled clinical trials which all showed an improvement in survival with a magnitude of approximately 35%. The purpose of our study was to test the hypothesis that the addition of chemotherapy improved survival in our patients. We identified 291 patients treated with primary 'intent-to-cure' radiation therapy for locally advanced carcinoma of the cervix between 1985 and 2000. We analyzed patients using a stepwise Cox regression, including as possible predictors: clinical stage, age at diagnosis, use of concurrent chemotherapy with radiation and method of teletherapy delivery. We also examined survival as a function of CRT with a CDDP and/or 5-FU containing regimen using the Kaplan-Meier estimates of overall survival. The use of concurrent CDDP and/or 5-FU chemotherapy with radiation (CRT) was not associated with an increase in disease free survival (p=0.734) or overall survival (p=0.989). In this retrospective study there was no disease free or overall survival benefit from the addition of CDDP and/or 5-FU chemotherapy to radical radiotherapy for the treatment of locally advanced cervical carcinoma, although there was a trend favoring CRT.

Micturition syncope during pregnancy.

BACKGROUND: Micturition syncope is a relatively uncommon cause of sudden and temporary loss of consciousness. Most prevalent in older males, this condition is extremely rare in women. CASES: Two pregnant women presented with recurrent syncope. The syncopal events were more common in the early morning and were precipitated by the presence of a distended bladder, urinary urgency, assuming a standing position after either being supine or sitting, or associated with travel motion. Extensive neurology and cardiology evaluations were negative, and the events were considered consistent with micturition syncope. Both patients responded favorably to conservative voiding behavior modification measures throughout the remainder of pregnancy. CONCLUSION: Micturition syncope during pregnancy may not be a rare occurrence. This potentially dangerous condition is amenable to voiding behavior modification measures.