- Email: [email protected]
Gynecologic tumors in tamoxifen-treated women with breast cancer
202
Citations from the Literature
(gonorrhea, chlamydia, trichomonas, or primary genital herpes) at the time of interview. Infection was associated with younger age and increasing numbers of non-paying sexual partners, but not with duration of prostitution, numbers of clients, or reports of condom failures. When age and numbers of nonpaying partners were analyzed by logistic regression they remained significantly associated with sexually transmitted infections. Conclusions A large and diverse sample of prostitutes had a low prevalence of infection with HIV and high levels of use of condoms in commercial sex. There was a significant risk of other sexually transmitted infections associated with prostitutes’ non-commercial sexual relationships, in which unprotected sex is common. Interventions to reduce the risk of sexually transmitted infections in prostitutes should address both commercial and noncommercial sexual partnerships. ProsthtIon aad risk of HIV: Male partners of female prostitutes
Day S.; Ward H.; Perrotta L. GBR BR MED J 1993 307/6900 (359-361) Objective To describe risk behaviors for infection with HIV in male sexual partners of female prostitutes. Design A cross sectional study. Setting Genitourinary medicine clinic, St Mary’s Hospital, London. Subjects 112 self identified male sexual partners of female prostitutes: 101 who reported commercial sexual relationships only, five who reported non-commercial relationships only, and six who reported both commercial and non-commercial relationships. Main outcome measures Reported risk behaviors for infection with HIV. Results Of the 40 men who had had previous HIV tests or were tested during the study, two (5%) were infected with HIV. Of the men who would answer the questions, 34/94 reported having sex with other men, 2/105 reported using injected drugs, 81105had a history of blood transfusion, l4/108 reported a past history of gonorrhea, 44/102 reported paying for sex abroad, and 8192 said that they had also been paid for sex. Of the 55 men who reported paying for vaginal intercourse in the past year, 45 (82%) said that they had always used a condom. In contrast, of the 11 non-paying partners of prostitutes, only two (18%) reported ever using a condom with their partners. Conclusions Men who have sex with female prostitutes cannot be assumed to be at risk of infection with HIV only by this route: homosexual contact may place them at greater risk. Despite the heterogeneity among male sexual partners of prostitutes, patterns of use of condoms were uniform when they were considered as a reflection of the type of relationship a man had with a female prostitute rather than a consequence of an individual’s level of risk.
ONCOLOGY Tax01 as a rndlation senslther: A flow cytometric study
Steren A.; Sevin B.-U.; Perras J.; Ramos R.; Angioli R.; Nguyen H.; Koechli 0.; Averette H.E. USA GYNECOL ONCOL 1993 SO/l (89-93) Taxol is an exciting antineoplastic agent with a novel mechaInt J Gynecol Obstet 45
nism of action. Taxol has been shown to prolong the GUM phase of the cell cycle. This cell cycle perturbation has been the explanation given for the radiation-sensitizing effects seen with taxol in vitro. The aim of this study is to evaluate the cell kinetics of the BG-I human ovarian cancer cell line after treatment with nontoxic doses of taxol and radiation (RT). This cell line was treated in the proliferative state for 90 min with 5 nM taxol and then irradiated 48 h later with 2 Gy of Cobalt60. Flow cytometric evaluations of cell cycle perturbations were performed at 24-h intervals from 0 through 216 hr. ATP cell viability assay was performed in parallel to obtain survival data. Survival data was tit to the linear-quadratic model and mean inactivation dose D was calculated. Data analysis with t test was performed. At this nontoxic dose of taxol no cell cycle perturbations as compared to control were seen. Radiation sensitization was still found. Sensitizer enhancement ratio was 2.3 at 10% survival. The RT-related G2/M block peaked at 24 h after RT and then resolved. The combination of taxol and radiation resulted in a large prolonged block in G2/M that did not resolve through the duration of the experiment. In summary, taxol sensitized cells to radiation at a dose that was not cytotoxic and that did not cause cell cycle perturbations.
Gynecologic tumors in tamoxifeibtreated
women with breast
cancer
Seoud M.A.-F.; Johnson J.; Weed J.C. Jr. USA OBSTET GYNECOL 1993 82/2 (165-169) Objectives: To present six additional cases of gynecologic tumors in tamoxifen-treated breast cancer patients, review the literature, and recommend measures for surveillance. Methods: The hospital and office records of patients treated with tamoxifen at the University of Kansas Medical Center and Research Medical Center were analyzed. A comprehensive review of tamoxifen in the English and European literature was performed using MEDLINE and the bibliographies of various articles. Results: From 1985-1992 at our institutions, six tamoxifentreated breast cancer patients developed gynecologic tumors: three endometrial adenocarcinomas, a mixed mullerian sarcoma, a fallopian tube carcinoma with adenolibroma of the endometrium, and recurrent hyperplastic endometrial polyps. The literature contained 61 cases of adenocarcinoma of the endometrium and possibly four cases of uterine sarcomas in tamoxifen-treated breast cancer patients. The number of gynecologic malignancies reported is now 70. In 35 of the patients, the mean age (t S.D.) was 63.9 f 12.0 years, and 61 of 66 patients (92.4%) were postmenopausal. Of the endometrial adenocarcinomas, 25 of 27 (92.6%) were stage I, and 11 of 27 (40.7%) were grade 1. The dose of tamoxifen was 20 mg/day in 15 (23.4%), 30 mg/day in II (17.2%), and 40 mg or higher in 38 (59.4%); 57% were treated with tamoxifen for less than 2 years. Conclusions: Tamoxifen is a safe and reliable treatment of breast cancer, but data suggest an association with endometrial cancer. We propose close monitoring of patients taking tamoxifen and prompt evaluation of any uterine bleeding or pelvic complaint.
Citations from the Literature
(gonorrhea, chlamydia, trichomonas, or primary genital herpes) at the time of interview. Infection was associated with younger age and increasing numbers of non-paying sexual partners, but not with duration of prostitution, numbers of clients, or reports of condom failures. When age and numbers of nonpaying partners were analyzed by logistic regression they remained significantly associated with sexually transmitted infections. Conclusions A large and diverse sample of prostitutes had a low prevalence of infection with HIV and high levels of use of condoms in commercial sex. There was a significant risk of other sexually transmitted infections associated with prostitutes’ non-commercial sexual relationships, in which unprotected sex is common. Interventions to reduce the risk of sexually transmitted infections in prostitutes should address both commercial and noncommercial sexual partnerships. ProsthtIon aad risk of HIV: Male partners of female prostitutes
Day S.; Ward H.; Perrotta L. GBR BR MED J 1993 307/6900 (359-361) Objective To describe risk behaviors for infection with HIV in male sexual partners of female prostitutes. Design A cross sectional study. Setting Genitourinary medicine clinic, St Mary’s Hospital, London. Subjects 112 self identified male sexual partners of female prostitutes: 101 who reported commercial sexual relationships only, five who reported non-commercial relationships only, and six who reported both commercial and non-commercial relationships. Main outcome measures Reported risk behaviors for infection with HIV. Results Of the 40 men who had had previous HIV tests or were tested during the study, two (5%) were infected with HIV. Of the men who would answer the questions, 34/94 reported having sex with other men, 2/105 reported using injected drugs, 81105had a history of blood transfusion, l4/108 reported a past history of gonorrhea, 44/102 reported paying for sex abroad, and 8192 said that they had also been paid for sex. Of the 55 men who reported paying for vaginal intercourse in the past year, 45 (82%) said that they had always used a condom. In contrast, of the 11 non-paying partners of prostitutes, only two (18%) reported ever using a condom with their partners. Conclusions Men who have sex with female prostitutes cannot be assumed to be at risk of infection with HIV only by this route: homosexual contact may place them at greater risk. Despite the heterogeneity among male sexual partners of prostitutes, patterns of use of condoms were uniform when they were considered as a reflection of the type of relationship a man had with a female prostitute rather than a consequence of an individual’s level of risk.
ONCOLOGY Tax01 as a rndlation senslther: A flow cytometric study
Steren A.; Sevin B.-U.; Perras J.; Ramos R.; Angioli R.; Nguyen H.; Koechli 0.; Averette H.E. USA GYNECOL ONCOL 1993 SO/l (89-93) Taxol is an exciting antineoplastic agent with a novel mechaInt J Gynecol Obstet 45
nism of action. Taxol has been shown to prolong the GUM phase of the cell cycle. This cell cycle perturbation has been the explanation given for the radiation-sensitizing effects seen with taxol in vitro. The aim of this study is to evaluate the cell kinetics of the BG-I human ovarian cancer cell line after treatment with nontoxic doses of taxol and radiation (RT). This cell line was treated in the proliferative state for 90 min with 5 nM taxol and then irradiated 48 h later with 2 Gy of Cobalt60. Flow cytometric evaluations of cell cycle perturbations were performed at 24-h intervals from 0 through 216 hr. ATP cell viability assay was performed in parallel to obtain survival data. Survival data was tit to the linear-quadratic model and mean inactivation dose D was calculated. Data analysis with t test was performed. At this nontoxic dose of taxol no cell cycle perturbations as compared to control were seen. Radiation sensitization was still found. Sensitizer enhancement ratio was 2.3 at 10% survival. The RT-related G2/M block peaked at 24 h after RT and then resolved. The combination of taxol and radiation resulted in a large prolonged block in G2/M that did not resolve through the duration of the experiment. In summary, taxol sensitized cells to radiation at a dose that was not cytotoxic and that did not cause cell cycle perturbations.
Gynecologic tumors in tamoxifeibtreated
women with breast
cancer
Seoud M.A.-F.; Johnson J.; Weed J.C. Jr. USA OBSTET GYNECOL 1993 82/2 (165-169) Objectives: To present six additional cases of gynecologic tumors in tamoxifen-treated breast cancer patients, review the literature, and recommend measures for surveillance. Methods: The hospital and office records of patients treated with tamoxifen at the University of Kansas Medical Center and Research Medical Center were analyzed. A comprehensive review of tamoxifen in the English and European literature was performed using MEDLINE and the bibliographies of various articles. Results: From 1985-1992 at our institutions, six tamoxifentreated breast cancer patients developed gynecologic tumors: three endometrial adenocarcinomas, a mixed mullerian sarcoma, a fallopian tube carcinoma with adenolibroma of the endometrium, and recurrent hyperplastic endometrial polyps. The literature contained 61 cases of adenocarcinoma of the endometrium and possibly four cases of uterine sarcomas in tamoxifen-treated breast cancer patients. The number of gynecologic malignancies reported is now 70. In 35 of the patients, the mean age (t S.D.) was 63.9 f 12.0 years, and 61 of 66 patients (92.4%) were postmenopausal. Of the endometrial adenocarcinomas, 25 of 27 (92.6%) were stage I, and 11 of 27 (40.7%) were grade 1. The dose of tamoxifen was 20 mg/day in 15 (23.4%), 30 mg/day in II (17.2%), and 40 mg or higher in 38 (59.4%); 57% were treated with tamoxifen for less than 2 years. Conclusions: Tamoxifen is a safe and reliable treatment of breast cancer, but data suggest an association with endometrial cancer. We propose close monitoring of patients taking tamoxifen and prompt evaluation of any uterine bleeding or pelvic complaint.