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Background: Concurrent chemoradiotherapy (CCRT) has not been extensively studied in patients with small cervical cancer tumors with no pelvic node enlargement., Patients and Methods: We retrospectively analyzed 55 patients with stage IB1-IIB cervical cancer and tumors of ≤40 mm with no pelvic node enlargement treated with radiotherapy (RT)-alone., Results: Cancer recurred in seven patients. Patient age (≤63 years) was identified as an independent factor for better disease-free survival (DFS) (p=0.027), and tumor size (≥25 mm) had a tendency to correlate with reduced locoregional DFS (p=0.089) by the Cox hazard model. Among patients aged 63 years or less, cancer recurred in five out of 18 patients with tumors of ≥25 mm, but in only one of 10 patients with tumors of ≤24 mm., Conclusion: In patients with stage IB1-IIB cervical cancer and small tumors with no node enlargement, CCRT may provide a better disease control for the group aged 63 years or less and with tumor size of 25 mm or more.

Aim: To retrospectively analyze the treatment results of postoperative radiotherapy (PORT) in patients with early-stage uterine cervical cancer., Patients and Methods: Records of 141 patients with stage IB-IIB uterine cervical cancer treated with PORT from 1985 to 2004 were retrospectively reviewed. The majority of patients received whole-pelvic radiotherapy with antero-posterior fields, and the total radiation doses ranged from 10.8-60 Gy (median: 50.4 Gy). The median follow-up of all 141 patients was 106 months (range: 0.8-273.7 months)., Results: Multivariate analysis revealed that positive lymph node status (p=0.001) and histological type (p=0.015) were independent prognostic factors for overall survival. The group with three or more involved lymph nodes was significantly more likely to have extra-pelvic recurrence when compared with the groups with no (p=0.006) and up to two lymph nodes (p=0.024), respectively., Conclusion: PORT yielded excellent pelvic control rates for early-stage uterine cervical cancer. Lymph node status and histological type were significant prognostic factors for overall survival of patients with these tumors.

Background: It is unclear whether cisplatin-based concurrent chemoradiotherapy (CCRT) has the same effect on adenocarcinoma as on squamous cell carcinoma., Patients and Methods: We retrospectively analyzed data for 32 patients with stage IIB-IVA cervical adenocarcinoma who were treated with radiotherapy (RT) or CCRT. Fourteen patients were treated with RT, 8 with CCRT using cisplatin alone (CCRT-P), and 10 with CCRT using cisplatin plus paclitaxel (CCRT-TP)., Results: Complete response was achieved in 7/14 patients in the RT group, 4/8 patients in the CCRT-P group, and 9/10 patients in the CCRT-TP group. Ten out of the 14 patients in the RT, 7/8 patients in the CCRT-P, and 2/10 patients in the CCRT-TP groups experienced locoregional recurrence. The 5-year overall survival rate in the RT, CCRT-P, and CCRT-TP groups was 7.1%, 25.0%, and 74.1%, respectively (p=0.0094)., Conclusion: The present study demonstrated that CCRT-TP achieved much better local control for adenocarcinoma of the cervix, leading to a decrease in locoregional recurrence.

Aim: Severe late complications, particularly radiation enterocolitis and leg edema, remain major problems in patients with uterine cancer, who have undergone hysterectomy and postoperative external beam radiotherapy (EBRT). We carried out this retrospective analysis to identify the incidence of risk factors for such complications., Patients and Methods: The records of 228 patients, who underwent radical hysterectomy and postoperative EBRT (uterine cervix: 149 patients; uterine corpus: 79 patients) were reviewed retrospectively. The majority of the patients (90.8%) were treated with 50 to 50.4 Gy EBRT in conventional fractionations with anteroposterior fields. Intracavitary brachytherapy (ICBT) was administered to 9 patients (3.9%), and 35 patients (15.2%) received chemotherapy. The median follow-up for all 228 patients was 81.7 months (range, 1-273 months)., Results: Nineteen patients (8.3%) developed severe radiation enterocolitis with a median latency of 12.6 months, and the ileum was the most frequently affected site. On multivariate analysis, smoking was an independent predictor of severe radiation enterocolitis. Nineteen patients (8.3%) developed severe leg edema with a median latency of 32.7 months. The degree of leg edema did not improve in any of the 19 patients despite intensive treatment. On multivariate analysis, addition of ICBT was an independent predictor of severe leg edema., Conclusion: Severe radiation enterocolitis and severe leg edema were each observed in approximately 8% of patients with uterine cancer, who underwent postoperative radiotherapy. Severe radiation enterocolitis correlated strongly with smoking, and severe leg edema correlated strongly with addition of ICBT. These factors should be considered before administering postoperative radiotherapy to uterine cancer patients.

Aim: To identify predictive factors for locoregional recurrence in patients with FIGO stage IB-IIB cervical cancer treated with concurrent chemoradiotherapy (CCRT)., Patients and Methods: Data were analyzed for 123 patients with FIGO stage IB-IIB squamous cell carcinoma of the cervix between 1997 and 2007. Eligibility for CCRT included tumor size >4 cm and/or lymph node enlargement over a minimum diameter of 1 cm., Results: Tumor size (≥5.2 cm) and age (<48 years) were independent predictive factors for locoregional recurrence by multivariate analysis. Based on these two factors, the patients were divided into low-risk (n=91) and high-risk (n=32) groups for locoregional recurrence. The 5-year disease-free survival for the low-risk group was 95.3%, which was significantly better than 65.5% for the high-risk group (p<0.0001). Locoregional recurrence was noted in 10 out of the 32 patients in the high-risk group compared to only 3 out of the 91 patients in the low-risk group., Conclusion: To improve locoregional control in the high-risk group, it may be worthwhile to consider CCRT using new radiosensitizing agents, adjuvant hysterectomy or adjuvant chemotherapy.

The aim of the present study was to examine whether crude glycosphingolipid (cGSL) has short-term chemopreventive effects on the preneoplastic biomarker lesions involved in carcinogen-induced rat colon carcinogenesis. We also examined whether cGSL affects cell proliferation and apoptosis in these lesions. The crude preparation was obtained by the simple ethanol extraction method. Five-week-old male F344 rats were divided into 6 groups. Rats in groups 1-4 were given subcutaneous injections of azoxymethane (AOM) (20 mg/kg body weight) once a week for 2 weeks. Starting 1 week before the first injection of AOM, the rats in groups 2, 3 and 4 were fed a diet containing 250, 1,000 and 3,000 ppm cGSL, respectively, for 5 weeks. The experiment was terminated 5 weeks after the start date, and the number of aberrant crypt foci (ACF) and mucin-depleted foci (MDF) was counted. Dietary cGSL significantly inhibited the induction of ACF (group 3, P<0.01; group 4, P<0.05) and MDF (groups 2 and 3, P<0.001; group 4, P<0.05) as compared to group 1 treated with AOM alone. In groups 3 and 4, proliferating cell nuclear antigen-positive indices of epithelial cells were significantly lower than in group 1 (group 3, P<0.05; group 4, P<0.005). Caspase-3-positive indices were significantly higher in groups 3 and 4 than in group 1 (group 3, P<0.01; group 4, P<0.001). These results suggest that dietary cGSL had a potent chemopreventive effect in the present short-term colon carcinogenesis bioassays, and that this effect may be associated with the inhibition of ACF and MDF and the induction of apoptosis.

The purpose of the present study was to examine whether Neem leaf (Azadirachta indica) has short-term chemopreventive effects on endpoint preneoplastic lesions involved in rat colon carcinogenesis and might also exert antioxidative activity. Forty- two male F344 rats were randomly divided into 6 experimental groups. Groups 1 to 4 were given a subcutaneous injection of azoxymethane (AOM, 20 mg/kg body weight) once a week for 2 weeks. Starting one week before the first injection of AOM, rats in groups 2 to 4 received an aqueous extract of Neem leaf (20, 100, and 250 mg/kg, respectively) by gavage 3 times per week, for 5 weeks. Rats in group 5 also were given the Neem extract by gavage feeding 3 times per week for 5 weeks, while group 6 served as untreated controls. The experiment was terminated 5 weeks after the start. Dietary feeding of the Neem extract at all dose levels significantly inhibited the induction of aberrant crypt foci (ACF) (P<0.0002), when compared to the AOM-treated group (group 1). In groups 2 to 4, treatment of rats with the Neem extract also significantly decreased the proliferating cell nuclear antigen (PCNA) labeling indices (P<0.0006) of colon epithelium and ACF. Moreover, the Neem extract also showed antioxidative activity. The finding that dietary Neem has possible chemopreventive effects in the present short-term colon carcinogenesis bioassay suggests that longer-term exposure may cause suppression of tumor development.

Background: O6-methylguanine-DNA methyltransferase (MGMT) is a DNA repair protein and protects DNA from the biological effects of alkylating carcinogens. The purpose of this study was to investigate the association between the mRNA expression level of the Mgmt gene and mutation of the beta-catenin gene in rat colon tumors induced by azoxymethane (AOM) plus dextran sulfate sodium (DSS)., Materials and Methods: Eleven tumor samples from rat colon treated by AOM plus DSS were examined. Mutation of the beta-catenin gene was identified by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis. The expression level of Mgmt mRNA was determined by reverse transcription-PCR (RT-PCR)., Results: Four out of five adeno-carcinoma samples bearing beta-catenin gene mutation (5 out of 11, 45%) displayed a decrease in expression levels of Mgmt mRNA (p<0.02)., Conclusion: These results suggest that the reduced expression of Mgmt mRNA and beta-catenin gene mutation may contribute to the development of rat colon tumors.