genital neoplasms, female

生殖器肿瘤,Female
  • 文章类型: Journal Article
    官方会议标签通常用于促进推文和社交媒体参与。在肿瘤学会议期间引入新标签的范围和影响尚待研究。美国临床肿瘤学会(ASCO)举行年度全球会议,由于2020年和2021年的COVID-19大流行,这完全是虚拟的。
    这项研究旨在评估ASCO2020和2021虚拟会议中新主题标签#goASCO20和#goASCO21的影响范围和影响(以生成的顶点和边的形式)和X(以前的Twitter)活动。
    为2020年和2021年的ASCO虚拟会议创建了新的主题标签(#goASCO20和#goASCO21),以帮助在ASCO会议上集中讨论妇科肿瘤学。使用这些标签检索数据(2020年为#goASCO20,2021年为#goASCO21)。使用NodeXL软件应用进行社交网络分析。
    标签#goASCO20和#goASCO21对社交网络产生了类似的影响。对各个主题标签的范围和影响的分析发现,#goASCO20具有150个顶点和2519个总边,而#goASCO20具有174个顶点和2062个总边。2020年至2021年之间的提及和推文也相似。代表不同用户的圆圈在2021年以更平衡的方式在空间上排列。使用#goASCO21标签的推文收到的回复明显多于使用#goASCO20的推文(2020年为75倍,2021年为360倍;z值=16.63,P<.001)。这表明下一年的参与有所增加。
    介绍了妇科肿瘤学专业特有的标签(#goASCO20和#goASCO21),该标签与官方会议标签(#ASCO20和#ASCO21)相关但不同,有助于在虚拟全肿瘤学会议期间促进对妇科肿瘤学家感兴趣的主题的讨论。这种影响在社交网络分析中可见。
    UNASSIGNED: Official conference hashtags are commonly used to promote tweeting and social media engagement. The reach and impact of introducing a new hashtag during an oncology conference have yet to be studied. The American Society of Clinical Oncology (ASCO) conducts an annual global meeting, which was entirely virtual due to the COVID-19 pandemic in 2020 and 2021.
    UNASSIGNED: This study aimed to assess the reach and impact (in the form of vertices and edges generated) and X (formerly Twitter) activity of the new hashtags #goASCO20 and #goASCO21 in the ASCO 2020 and 2021 virtual conferences.
    UNASSIGNED: New hashtags (#goASCO20 and #goASCO21) were created for the ASCO virtual conferences in 2020 and 2021 to help focus gynecologic oncology discussion at the ASCO meetings. Data were retrieved using these hashtags (#goASCO20 for 2020 and #goASCO21 for 2021). A social network analysis was performed using the NodeXL software application.
    UNASSIGNED: The hashtags #goASCO20 and #goASCO21 had similar impacts on the social network. Analysis of the reach and impact of the individual hashtags found #goASCO20 to have 150 vertices and 2519 total edges and #goASCO20 to have 174 vertices and 2062 total edges. Mentions and tweets between 2020 and 2021 were also similar. The circles representing different users were spatially arranged in a more balanced way in 2021. Tweets using the #goASCO21 hashtag received significantly more responses than tweets using #goASCO20 (75 times in 2020 vs 360 times in 2021; z value=16.63 and P<.001). This indicates increased engagement in the subsequent year.
    UNASSIGNED: Introducing a gynecologic oncology specialty-specific hashtag (#goASCO20 and #goASCO21) that is related but different from the official conference hashtag (#ASCO20 and #ASCO21) helped facilitate discussion on topics of interest to gynecologic oncologists during a virtual pan-oncology meeting. This impact was visible in the social network analysis.
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  • 文章类型: Journal Article
    妇科癌症的发病率和死亡率会显著影响女性的生活质量,并增加全球组织的医疗保健负担。这项研究的目的是根据2022年全球癌症观察站(GLOBOCAN)的估计,评估2022年全球妇科癌症发病率和死亡率的不平等。还预测了2050年妇科癌症(GC)的未来负担。
    与妇科癌症相关的总病例和死亡数据,以及与不同亚型GCs有关的病例和死亡,从2022年的GLOBOCAN数据库中收集。对2050年病例和死亡人数的预测来自全球人口预测,按世界区域和人类发展指数(HDI)分类。
    2022年,有1473427例新的GCs病例和680372例死亡。妇科癌症的发病率达到30.3/100000,死亡率达到13.2/100000。东非的GCs的年龄标准化发病率高于每100000人中50人,而北非的年龄标准化发病率为每100000人中17.1人。东非的死亡率最高(ASMR(年龄标准化死亡率)为每100000人35.3),澳大利亚和新西兰的死亡率最低(ASMR为每100000人8.1)。这些与HIV和HPV的流行地区有关。非常高的人类发展指数国家的GCs发病率最高,ASIR(年龄标准化发病率)为34.8/100000,而低HDI国家的发病率第二高,ASIR为33.0/100000。埃斯瓦蒂尼的发病率和死亡率最高(105.4/100000;71.1/100000),也门最低(5.8/100000;4.4/100000)。如果保持目前的发病率和死亡率趋势,女性生殖道肿瘤的新病例和死亡人数预计将在未来二十年内增加。
    2022年,妇科癌症占全球1473427例新病例和680372例死亡。在发病率和死亡率方面存在显著的地区差异。在东非和人类发展指数很高和很低的国家观察到了最高的比率,埃斯瓦蒂尼记录了最严重的统计数据。如果目前的趋势继续下去,妇科癌症的新病例和死亡人数预计将在未来二十年内上升,强调迫切需要有效的干预措施。
    UNASSIGNED: The incidence and mortality of gynaecological cancers can significantly impact women\'s quality of life and increase the health care burden for organisations globally. The objective of this study was to evaluate global inequalities in the incidence and mortality of gynaecological cancers in 2022, based on The Global Cancer Observatory (GLOBOCAN) 2022 estimates. The future burden of gynaecological cancers (GCs) in 2050 was also projected.
    UNASSIGNED: Data regarding to the total cases and deaths related to gynaecological cancer, as well as cases and deaths pertaining to different subtypes of GCs, gathered from the GLOBOCAN database for the year 2022. Predictions for the number of cases and deaths in the year 2050 were derived from global demographic projections, categorised by world region and Human Development Index (HDI).
    UNASSIGNED: In 2022, there were 1 473 427 new cases of GCs and 680 372 deaths. The incidence of gynecological cancer reached 30.3 per 100 000, and the mortality rate hit 13.2 per 100 000. The age-standardised incidence of GCs in Eastern Africa is higher than 50 per 100 000, whereas the age-standardised incidence in Northern Africa is 17.1 per 100 000. The highest mortality rates were found in East Africa (ASMR (age-standardised mortality rates) of 35.3 per 100 000) and the lowest in Australia and New Zealand (ASMR of 8.1 per 100 000). These are related to the endemic areas of HIV and HPV. Very High HDI countries had the highest incidence of GCs, with ASIR (age-standardised incidence rates) of 34.8 per 100 000, and low HDI countries had the second highest incidence rate, with an ASIR of 33.0 per 100 000. Eswatini had the highest incidence and mortality (105.4 per 100 000; 71.1 per 100 000) and Yemen the lowest (5.8 per 100 000; 4.4 per 100 000). If the current trends in morbidity and mortality are maintained, number of new cases and deaths from female reproductive tract tumours is projected to increase over the next two decades.
    UNASSIGNED: In 2022, gynaecological cancers accounted for 1 473 427 new cases and 680 372 deaths globally, with significant regional disparities in incidence and mortality rates. The highest rates were observed in Eastern Africa and countries with very high and low HDI, with Eswatini recording the most severe statistics. If current trends continue, the number of new cases and deaths from gynaecological cancers is expected to rise over the next two decades, highlighting the urgent need for effective interventions.
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  • 文章类型: Journal Article
    UNASSIGNED: Therapeutic exercise has an important role in the population living with cancer as it improves function and quality of life and reduces the symptoms of cancer treatment. There is little clinical evidence on the effects of hypopressive exercise in women with gynecological cancer.
    UNASSIGNED: Evaluate the effects of 4 weeks of hypopressive exercise associated with muscle strength training and aerobic exercises on fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecological cancer compared to a group that will perform conventional training.
    UNASSIGNED: This randomized, single-blinded clinical trial study is set in the Clinical Research Laboratory, Department of Kinesiotherapy, at a Chilean University. Patients will be randomly assigned to an experimental group of hypopressive exercises associated with muscle strength training and aerobic exercises or a control group of muscle strength training and aerobic exercises. Twelve tele-rehabilitation sessions will be performed. Women over 18 years of age with gynecologic cancer who have been prescribed radiotherapy or chemotherapy will participate. Fatigue, quality of life, urinary incontinence symptoms, and sexual function will be assessed before and after the intervention.
    UNASSIGNED: The results of this clinical trial have important implications for specific treatment for the cancer population and generate new techniques in the practice of oncology-specialized kinesiologists. Hypopressive exercise is expected to reduce incontinence symptoms due to neuromuscular activation of the pelvic floor muscles. However, more studies are needed to confirm the beneficial effects of hypopressive exercises in face-to-face or remote rehabilitation.
    UNASSIGNED: El ejercicio terapéutico juega un rol importante en la población con cáncer, ya que mejora la función, la calidad de vida y reduce los síntomas del tratamiento contra el cáncer. Hay poca evidencia clínica sobre los efectos del ejercicio hipopresivo en mujeres con cáncer ginecológico.
    UNASSIGNED: Evaluar los efectos de cuatro semanas de ejercicio hipopresivo asociado con entrenamiento de fuerza muscular y ejercicios aeróbicos sobre la fatiga, los síntomas de incontinencia urinaria, la función sexual y la calidad de vida en mujeres tratadas por cáncer ginecológico, en comparación con un grupo que realizará entrenamiento convencional.
    UNASSIGNED: El escenario para este estudio de ensayo clínico aleatorizado y simple ciego es el Laboratorio de Investigación Clínica, Departamento de Kinesiología, en una Universidad Chilena. Las pacientes serán asignadas aleatoriamente a un grupo experimental de ejercicios hipopresivos asociados con entrenamiento de fuerza muscular y ejercicios aeróbicos, o a un grupo de control de entrenamiento de fuerza muscular y ejercicios aeróbicos. Se realizarán doce sesiones de telerehabilitación. Participarán mujeres mayores de 18 años con cáncer ginecológico a quienes se les haya indicado radioterapia o quimioterapia. Se evaluarán la fatiga, la calidad de vida, los síntomas de incontinencia urinaria y la función sexual antes y después de la intervención.
    UNASSIGNED: esperados Los resultados de este ensayo clínico tienen importantes implicaciones en términos del tratamiento específico para la población con cáncer y generan nuevas técnicas en la práctica de kinesiólogos especializados en oncología. Se espera que el ejercicio hipopresivo reduzca los síntomas de incontinencia debido a la activación neuromuscular de los músculos del suelo pélvico. Sin embargo, se necesitan más estudios para confirmar los efectos beneficiosos de los ejercicios hipopresivos, ya sea en rehabilitación presencial o a distancia.
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  • 文章类型: Journal Article
    在过去的几十年里,免疫检查点抑制剂(ICIs)在提高多种恶性肿瘤的生存率方面显示出显著的疗效.最近,妇科癌症患者对ICI治疗也表现出良好的反应.本研究旨在评估疗效,安全,和患者报告的妇科癌症ICI治疗结果。我们通过从多个电子数据库中检索文献进行了系统综述和荟萃分析,比如MEDLINE,ScienceDirect,EBSCO,ProQuest,谷歌学者。本研究中使用的方案已在PROSPERO(CRD42022369529)中注册。我们共纳入12项试验,涉及8种疗法和8034例患者。与对照组相比,ICI组显示出更长的OS(HR:0.807;95%CI:0.719,0.907;p=0.000)和更大的PFS改善(HR:0.809;95%CI:0.673,0.973;p=0.024)。治疗相关不良事件发生率无显著差异[RR:0.968;95CI:0.936,1.001;p=0.061],但ICI组的免疫相关不良事件(IRAE)发生率较高(RR:3.093;95CI:1.933,4.798;p=0.000).尽管两组的QOL评分相对于基线的平均变化没有显着差异(SMD:0.048;95%CI:-0.106,0.202;p=0.542),ICI组患者达到最终QOL恶化的时间更长(HR:0.508;95%CI:0.461,0.560;p=0.000).尽管IRAE的发病率较高,显示ICI可改善患者的生存率和生活质量。因此,它应该被视为妇科癌症护理的新标准,尤其是在高级阶段。
    Over the past decades, immune checkpoint inhibitors (ICIs) have shown dramatic efficacy in improving survival rates in multiple malignancies. Recently, gynecological cancer patients also showed to respond favorably to ICI treatment. This study aimed to evaluate the efficacy, safety, and patient-reported outcomes of ICI therapy in gynecological cancers. We conducted a systematic review and meta-analysis by retrieving literature from multiple electronic databases, such as MEDLINE, ScienceDirect, EBSCO, ProQuest, and Google Scholar. The protocol used in this study has been registered in PROSPERO (CRD42022369529). We included a total of 12 trials involving 8 therapies and 8,034 patients. ICI group demonstrated a longer OS (HR: 0.807; 95% CI: 0.719, 0.907; p = 0.000) and greater PFS improvement (HR: 0.809; 95% CI: 0.673, 0.973; p = 0.024) compared to the control group. There was no significant difference in the incidence of treatment-related adverse events [RR: 0.968; 95%CI: 0.936, 1.001; p = 0.061], but a higher incidence of immune-related adverse events (IRAEs) was observed in the ICI group (RR: 3.093; 95%CI: 1.933, 4.798; p = 0.000). Although the mean changes of QOL score from baseline was not significantly different between both groups (SMD: 0.048; 95% CI: -0.106, 0.202; p = 0.542), the time to definitive QOL deterioration was longer in the ICI group (HR: 0.508; 95% CI: 0.461, 0.560; p = 0.000). Despite having a higher incidence of IRAE, ICI was shown to improve survival rates and QOL of patients. Thus, it should be considered as a new standard of care for gynecologic cancers, especially in advanced stages.
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  • 文章类型: Journal Article
    晚期妇科癌症患者忍受由疾病本身和他们所接受的治疗引起的许多症状。这种症状负担显著影响患者及其护理人员的生活质量。以及不断升级的医疗费用。姑息治疗提供了缓解这些挑战的解决方案。然而,在韩国,人们对姑息治疗的认识水平很低,因此,利用率低。为韩国晚期妇科癌症患者提供及时的姑息治疗需要全面了解他们的症状负担,姑息治疗知识,和姑息治疗的需要。然而,以前没有研究解决这个关键问题.本研究的目的是根据患者的人口统计学和临床特征,确定晚期妇科癌症对韩国姑息治疗需求的影响,症状负担,和姑息治疗知识。这项研究是对115名III或IV期妇科癌症患者的描述性横断面研究,通过在线问卷收集。主要变量是症状负担(癌症治疗的功能评估-一般),姑息治疗知识(姑息治疗知识量表),和姑息治疗需求(姑息治疗问卷中的问题和需求-简短版本)。使用多重层次回归分析来确定变量之间的关系。姑息治疗需求分为感知问题和专业支持请求。最常见的问题是财务问题,心理问题,和身体症状,最常见的专业支持请求是财务问题,心理问题,以及对信息的需求。感知到的问题分数随着年龄的增长而增加,没有手术经验,和显著的症状负担。此外,卵巢癌患者对专业支持评分的要求上升,没有手术史,严重的症状负担,和有限的姑息治疗知识。晚期妇科癌症患者的姑息治疗需求根据患者特征而有所不同,症状负担,和姑息治疗知识。确定影响姑息治疗需求的因素可以帮助临床医生确定需要姑息治疗的目标群体,并为他们提供专业的姑息治疗。
    Advanced gynecological cancer patients endure numerous symptoms resulting from both the disease itself and the treatments they undergo. This symptom burden significantly impacts the quality of life for both patients and their caregivers, as well as escalating medical costs. Palliative care presents a solution to alleviate these challenges. However, in Korea, there exists a low level of awareness regarding palliative care and consequently, a low utilization rate. Providing timely palliative care to advanced gynecological cancer patients in Korea necessitates a comprehensive understanding of their symptom burden, palliative care knowledge, and palliative care needs. However, no previous studies have addressed this critical issue. The purpose of this study is to determine the impact of advanced gynecological cancer on palliative care needs in Korea according to patient demographic and clinical characteristics, symptom burden, and palliative care knowledge. This study was a descriptive cross-sectional study of data from 115 participants with stage III or IV gynecological cancer, collected through an online questionnaire. The main variables were symptom burden (Functional Assessment of Cancer Therapy-General), palliative care knowledge (Palliative Care Knowledge Scale), and palliative care needs (Problems and Needs in Palliative Care questionnaire-short version). Multiple hierarchical regression analyses were used to determine the relationships between variables. Palliative care needs were divided into perceived problems and requests for professional support. The most common perceived problems were financial problems, psychological issues, and physical symptoms, and the most frequent requests for professional support were financial problems, psychological issues, and the need for information. The perceived problem score increased with age, not having surgical experience, and significant symptom burden. Additionally, the requests for professional support score rose in cases of ovarian cancer, not having surgical history, substantial symptom burden, and limited palliative care knowledge. Advanced gynecological cancer patients have palliative care needs that differ according to patient characteristics, symptom burden, and palliative care knowledge. Identifying factors influencing palliative care needs can aid clinicians in identifying target groups in need of palliative care and providing them with professional palliative care.
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  • 文章类型: Journal Article
    根据磁共振成像(MRI)的影像学表现评估妇科肿块病变并回顾其形态学特征,并将MRI结果与组织病理学结果相关联,是我们研究的中心主题.这项观察性横断面研究是对60例经体检和/或超声检查后临床怀疑有妇科肿块病变的女性患者进行的,在2022年6月至2023年7月之间的1年期间,在三级保健医院转诊接受MRI检查。观察到广泛的妇科肿块鉴别诊断。在我们的研究中,良性与恶性疾病的比例为1.6:1,其中良性37例,恶性23例.最常见的良性肿块是子宫肌瘤(n=14;23.3%),其次是子宫内膜异位症(n=8;13.3%),和卵巢皮样囊肿(n=4;6.6%)。在恶性病变中,宫颈癌是最常见的(n=11;18.3%),其次是子宫内膜癌(n=7;11.6%),卵巢癌(n=3;5%),和阴道癌(n=2;3%)。良性病变大多在T1加权成像上表现为低等强度,在T2加权成像上表现为高强度,而恶性病变在T1加权成像上出现等强度,在T2加权成像上出现高强度。出血和脂肪在MRI上得到了很好的评价,并有助于诊断。8个子宫内膜异位囊肿中有7个存在T2阴影,表现出100%的特异性和83%的灵敏度。为了确定宫颈癌的宫旁浸润,MRI显示准确率为91%,100%的特异性,和积极的预测值,负预测值,灵敏度为100%,75%,88%,分别。在子宫内膜癌的情况下,MRI显示的敏感性和特异性分别为87%和91%,分别,对于确定大于50%的肌层浸润,阳性预测值为87%,阴性预测值为91%。与其他模式相比,MRI提供了有关子宫和附件肿块及周围结构的大量信息,促进病变的准确分期。
    Evaluating gynecological mass lesions and reviewing their morphological characteristics based on their imaging appearance on magnetic resonance imaging (MRI), and correlating the MRI findings with histopathological findings, was the central theme of our study. This observational cross-sectional study was conducted on 60 female patients with clinically suspected gynecological mass lesions upon physical examination and/or ultrasonography, referred for MRI at a tertiary care hospital over a 1-year period between June 2022 and July 2023. A broad spectrum of differential diagnoses of gynecological masses was observed. In our study, the ratio of benign versus malignant disease was 1.6:1, with 37 benign and 23 malignant masses identified. The most common benign masses were uterine fibroids (n = 14; 23.3%), followed by endometriosis (n = 8; 13.3%), and ovarian dermoid cysts (n = 4; 6.6%). Among the malignant lesions, cervical cancer was the most common (n = 11; 18.3%), followed by endometrial carcinoma (n = 7; 11.6%), ovarian carcinoma (n = 3; 5%), and vaginal carcinoma (n = 2; 3%). Benign lesions mostly appeared hypo- to isointense on T1-weighted imaging and iso- to hyperintense on T2-weighted imaging, while malignant lesions appeared isointense on T1-weighted and hyperintense on T2-weighted imaging. Hemorrhage and fat were well appreciated on MRI and aided in diagnosis. T2 shading was present in 7 out of 8 endometriotic cysts, demonstrating a specificity of 100% and a sensitivity of 83%. For determining parametrial invasion in cervical carcinoma, MRI showed an accuracy of 91%, specificity of 100%, and positive predictive value, negative predictive value, and sensitivity of 100%, 75%, and 88%, respectively. In cases of endometrial carcinoma, MRI demonstrated a sensitivity and specificity of 87% and 91%, respectively, with a positive predictive value of 87% and a negative predictive value of 91% for identifying myometrial invasion greater than 50%. Compared to other modalities, MRI provided substantial information regarding uterine and adnexal masses and surrounding structures, facilitating accurate staging of lesions.
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  • 文章类型: Journal Article
    高剂量率近距离放射治疗是一种用于妇科癌症的治疗技术,其中腔内涂抹器放置在患者的盆腔内。为了确保准确的辐射输送,在插入时涂药器的定位是至关重要的。这项研究提出了一种新的获取方法,注册,并融合三维(3D)经腹和3D经直肠超声(US)图像,以在妇科近距离放射治疗期间可视化盆腔解剖结构和应用器。使用定制的多模态骨盆体对工作流程进行了验证,并在两个患者程序中进行了演示。对三种类型的腔内涂抹器进行了实验:环形和串联,与间质针环状串联,和串联和卵形。融合的3DUS图像与磁共振(MR)和计算机断层扫描(CT)图像进行配准以进行验证。计算目标配准误差(TRE)和基准定位误差(FLE)以量化我们的融合技术的准确性。对于幻影和患者图像,所有模态配准的TRE和FLE(3DUS与MR或CT)导致平均值±标准偏差为4.01±1.01mm和0.43±0.24mm,分别。这项工作表明了利用3DUS成像进行进一步临床研究的概念证明,可替代的先进的方式定位近距离放射治疗施药器。
    High dose-rate brachytherapy is a treatment technique for gynecologic cancers where intracavitary applicators are placed within the patient\'s pelvic cavity. To ensure accurate radiation delivery, localization of the applicator at the time of insertion is vital. This study proposes a novel method for acquiring, registering, and fusing three-dimensional (3D) trans-abdominal and 3D trans-rectal ultrasound (US) images for visualization of the pelvic anatomy and applicators during gynecologic brachytherapy. The workflow was validated using custom multi-modal pelvic phantoms and demonstrated during two patient procedures. Experiments were performed for three types of intracavitary applicators: ring-and-tandem, ring-and-tandem with interstitial needles, and tandem-and-ovoids. Fused 3D US images were registered to magnetic resonance (MR) and computed tomography (CT) images for validation. The target registration error (TRE) and fiducial localization error (FLE) were calculated to quantify the accuracy of our fusion technique. For both phantom and patient images, TRE and FLE across all modality registrations (3D US versus MR or CT) resulted in mean ± standard deviation of 4.01 ± 1.01 mm and 0.43 ± 0.24 mm, respectively. This work indicates proof of concept for conducting further clinical studies leveraging 3D US imaging as an accurate, accessible alternative to advanced modalities for localizing brachytherapy applicators.
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  • 文章类型: Journal Article
    目的:研究辅助生殖技术(ART)在妇科癌症患者中的生殖结局,并评估母婴并发症。
    方法:本研究包括2013年至2021年在上海集爱遗传和IVF研究所接受首次体外受精/卵胞浆内单精子注射(IVF/ICSI)治疗的被诊断为妇科癌症的女性。无任何癌症史的不孕妇女与癌症组相匹配。主要结果是累积活产率。使用正态分布变量的Student\'st检验和分类变量的卡方检验比较各组之间的基线和随访数据。采用基于倾向评分的患者匹配方法,以确保有和没有特定癌症类型的个体之间的可比性。
    结果:本研究共纳入了136例有妇科癌症史的患者和241例健康不孕对照。子宫内膜癌占病例的50.70%,宫颈癌占病例的34.60%。癌症组表现出明显更短的刺激持续时间,较低水平的雌二醇,回收的卵母细胞数量较少,第3天的胚胎,囊胚与对照组比较(P<0.05)。妇科癌症组的累积活产率明显低于对照组(36.10%vs.60.50%,P<0.001)。母婴并发症组间差异无统计学意义(P>0.05)。子宫内膜癌和宫颈癌组的累积活产率显着低于其匹配的对照组(38.60%vs.64.50%,P=0.011和24.20%vs.68.60%,分别为P<0.001)。
    结论:这些发现强调了接受ART的女性妇科癌症患者的妊娠和活产发生率下降,特别是子宫内膜癌和宫颈癌。这些发现对于接受ART的妇科癌症患者的咨询和管理具有重要意义。
    OBJECTIVE: To examine the reproductive outcomes of assisted reproductive technology (ART) in gynecologic cancer patients and to assess maternal and neonatal complications.
    METHODS: Women diagnosed with gynecologic cancer who underwent their first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment between 2013 and 2021 at Shanghai Ji Ai Genetics and IVF Institute were included in this study. Infertile women without any history of cancer were matched to the cancer group. The primary outcome was the cumulative live birth rate. Baseline and follow-up data were compared between groups using Student\'s t-tests for normally distributed variables and with Chi-square test for categorical variables. A propensity score-based patient-matching approach was adopted to ensure comparability between individuals with and without specific cancer type.
    RESULTS: A total of 136 patients with a history of gynecologic cancer and 241 healthy infertile controls were included in this study. Endometrial cancer constituted 50.70% of the cases and cervical cancer constituted 34.60% of the cases. The cancer group exhibited significantly shorter duration of stimulation, lower levels of estradiol, lower number of retrieved oocytes, day-3 embryos, and blastocysts compared to the control group (P < 0.05). The cumulative live birth rate of the gynecologic cancer group was significantly lower than that of the control group (36.10% vs. 60.50%, P < 0.001). Maternal and neonatal complications did not significantly differ between the groups (P > 0.05). The endometrial cancer and cervical cancer groups showed significantly lower cumulative live birth rates than their matched controls (38.60% vs. 64.50%, P = 0.011 and 24.20% vs. 68.60%, P < 0.001, respectively).
    CONCLUSIONS: These findings highlight the decreased occurrence of pregnancy and live birth in female gynecologic cancer patients undergoing ART, particularly in endometrial cancers and cervical cancers. These findings have important implications for counseling and managing gynecologic cancer patients undergoing ART.
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  • 文章类型: Journal Article
    目的:评估高剂量率(HDR)近距离放射治疗(BT)的妇科癌症患者的放射(RT)与RT后反转恢复超短回波时间(IR-UTE)MRI信号强度(SI)之间的关系。
    方法:7例患者接受了全骨盆RT(WPRT),随后接受BT至高风险临床目标体积(HR-CTV)。在三个时间点采集MR图像;RT前,WPRT后/BT前,BT后3-6个月。弥漫性纤维化(FDiffuse)用非对比双回波IR(反转时间[TI]=60ms)UTE研究应用程序成像,用图像减去后来的回声,只保留超短回波SI。致密纤维化(FDense)成像利用单回波晚钆增强IR-UTE,Gadavist注射后15分钟获得。将所得的FDiffuse和FDenseSI标准化为相应的臀肌SI。基于正常组织解剖结构在时间点之间可变形地配准图像。使用多参数MRI分割两个时间点的残余肿瘤。轮廓对应的50%,100%,150%,并创建处方BT剂量的200%等剂量线(IDL)。计算(i)每个IDL轮廓和(ii)残留肿瘤内的平均FDiffuse和FDenseSI。BT后扩散和FDenseSI与规定的BT剂量相关。为了确定BT剂量与IR-UTESI之间的关系,使用配对t检验和Bonferroni校正确定IDL之间BT后FDense的差异.
    结果:FDense在6/7例患者的高剂量区域较高,在100%和50%IDL中,平均±SD值为357±103%和331±97%(p=0.03),分别。在150%和50%IDL的反应区域中,高剂量区域的FDense较高,平均±SD值为380±122%和356±135%(p=.03),分别。在分段的残余肿瘤内,处方剂量的增加与BT后FDense的增加相关(n=5,r=.89,p=.04)。BT后扩散与100%IDL内的规定BT剂量负相关(n=7,r=-.83,p=.02)。
    结论:结果表明,BT后3-6个月的FDenseSI是组织对异质BT辐射剂量反应的敏感指标。未来的研究将验证FDiffuse和FDense是否是纤维化辐射反应的准确生物标志物。
    OBJECTIVE: To evaluate the relationship between delivered radiation (RT) and post-RT inversion-recovery ultrashort-echo-time (IR-UTE) MRI signal-intensity (SI) in gynecologic cancer patients treated with high-dose-rate (HDR) brachytherapy (BT).
    METHODS: Seven patients underwent whole-pelvis RT (WPRT) followed by BT to the high-risk clinical target volume (HR-CTV). MR images were acquired at three time-points; pre-RT, post-WPRT/pre-BT, and 3-6 months post-BT. Diffuse-fibrosis (FDiffuse) was imaged with a non-contrast dual-echo IR (inversion time [TI] = 60 ms) UTE research application, with image-subtraction of the later echo, only retaining the ultrashort-echo SI. Dense-fibrosis (FDense) imaging utilized single-echo Late-Gadolinium-Enhanced IR-UTE, acquired ∼ 15 min post-Gadavist injection. Resulting FDiffuse and FDense SI were normalized to the corresponding gluteal-muscle SI. Images were deformably registered between time-points based on normal tissue anatomy. The remnant tumor at both time-points was segmented using multi-parametric MRI. Contours corresponding to the 50%, 100%, 150%, and 200% isodose lines (IDLs) of the prescription BT-dose were created. Mean FDiffuse and FDense SI within (i) each IDL contour and (ii) the remnant tumor were calculated. Post-BT FDiffuse and FDense SI were correlated with prescribed BT-dose. To determine the relationship between BT-dose and IR-UTE SI, the differences in the post-BT FDense across IDLs was determined using paired t-tests with Bonferroni correction.
    RESULTS: FDense was higher in regions of higher dose for 6/7 patients, with mean ± SD values of 357 ± 103% and 331 ± 97% (p = .03) in the 100% and 50% IDL, respectively. FDense was higher in regions of higher dose in the responsive regions with mean ± SD values of 380 ± 122% and 356 ± 135% (p = .03) in the 150% and 50% IDL, respectively. Within the segmented remnant tumor, an increase in prescribed dose correlated with an increase in FDense post-BT (n = 5, r = .89, p = .04). Post-BT FDiffuse inversely correlated (n = 7, r = -.83, p = .02) with prescribed BT-dose within the 100% IDL.
    CONCLUSIONS: Results suggest that FDense SI 3-6 months post-BT is a sensitive measure of tissue response to heterogeneous BT radiation-dose. Future studies will validate whether FDiffuse and FDense are accurate biomarkers of fibrotic radiation response.
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  • 文章类型: Editorial
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