This study aimed to evaluate the efficacy and safety of computed tomography-magnetic resonance imaging (CT-MRI)-guided multi-catheter interstitial brachytherapy for patients with bulky (≥4 cm) and high-risk, stage IIB–IVB advanced cervical cancer. Eighteen patients who underwent concurrent chemoradiotherapy with multi-catheter interstitial brachytherapy between September 2014 and August 2020 were enrolled. The prescribed dose of external beam radiotherapy was 45–50.4 Gy, and the brachytherapy high-dose-rate aim was 25–30 Gy per 5 fractions. The endpoints were four-year local and pelvic control rates, four-year disease-free and overall survival rates, and the adverse events rate. The median follow-up period was 48.4 months (9.1–87.5 months). Fifteen patients received concurrent cisplatin therapy (40 mg/m², q1week). Four (22.2%), seven (38.9%), and seven (38.9%) patients had stage II, III, and IV cervical cancer, respectively. Pelvic and para-aortic lymph node metastases were observed in 11 (61.1%) and 2 (11.1%) patients, respectively. The median pre-treatment volume was 87.5 cm³. The four-year local control, pelvic control, disease-free survival, and overall survival rates were 100%, 100%, 81.6%, and 87.8%, respectively. Three (16.7%) patients experienced grade 3 adverse events, and none experienced grade 4–5 adverse events. CT-MRI-guided multi-catheter interstitial brachytherapy could be a promising treatment strategy for locally advanced cervical cancer.

The clinical outcomes in patients with ovarian cancer have been significantly improved by Poly(adenosine diphosphate–ribose) polymerase inhibitors (PARP-is). However, the best therapeutic strategy for recurrence during PARP-i maintenance therapy remains unknown. Herein, we elucidated the efficacy of platinum-based chemotherapy after PARP-i treatment in recurrent ovarian cancer. Eligible patients had experienced relapses during PARP-i maintenance therapy lasting at least 6 months and had received subsequent platinum-based chemotherapy at our institution between January 2019 and March 2024. Progression-free survival (PFS), overall survival (OS), and risk factors for PFS were evaluated. Sixty-six patients were assessed for eligibility and eighteen were enrolled. The median follow-up period was 14.5 months. The PFS and OS of all patients were 6.5 and 17.6 months, respectively. The evaluation of the risk factors for PFS revealed that age, pathological type, duration of PARP-i maintenance therapy, prior lines of chemotherapy, and PARP-i dose reduction were not significant prognostic markers. However, bevacizumab use in subsequent therapies significantly extended the PFS. The median PFS was 3.1 months in the chemotherapy-alone group and 8.9 months in the chemotherapy with bevacizumab group (log-rank p = 0.022). Platinum-based chemotherapy with bevacizumab in subsequent therapies would provide substantial benefits in the PFS of patients with recurrent ovarian cancer.

Cisplatin resistance poses a substantial barrier to the successful treatment of advanced endometrial cancer. Glucose deprivation in the tumor microenvironment, resulting from inadequate vascularization and rapid proliferation of cancer cells, may promote chemoresistance by modifying cellular metabolism and survival pathways. This study aimed to elucidate how glucose deprivation induces cisplatin resistance in endometrial cancer cells, focusing on the role of solute carrier family 7 member 11 (SLC7A11, xCT). The endometrial cancer cell lines HEC-1A and AN3CA were cultured under glucose-deprived and glucose-supplemented conditions. Cisplatin half-maximal inhibitory concentration (IC50) values, SLC7A11 expression, and reactive oxygen species (ROS) levels were assessed using cell proliferation assays, real-time PCR, Western blotting, and fluorescence assays. SLC7A11 was inhibited using small interfering RNA (siRNA) knockdown and the selective inhibitor HG106. Cisplatin-resistant cell lines were generated to evaluate the effect of SLC7A11 inhibition. Glucose deprivation significantly decreased cisplatin sensitivity and increased cisplatin IC50 values (P < 0.05). This reduction in sensitivity was accompanied by upregulation of SLC7A11 expression and decreased ROS levels (P < 0.05). Inhibition of SLC7A11, either by siRNA or HG106, increased cisplatin sensitivity and ROS production, even in cisplatin-resistant cells (P < 0.05). This effect was reversible with the antioxidant N-acetylcysteine. These findings demonstrate that glucose deprivation induces cisplatin resistance in endometrial cancer cells by upregulating SLC7A11, leading to reduced ROS levels and enhanced cell survival. Targeting SLC7A11 restores cisplatin sensitivity by elevating ROS production, even in cisplatin-resistant cells. The findings suggest that SLC7A11 is a promising therapeutic target for overcoming chemoresistance in endometrial cancer, potentially improving treatment outcomes and patient survival.

Diagnostic laparoscopy is useful in the management of gynecological cancers; however, it can occasionally result in the detection of other malignancies. Occult breast cancer (OBC) is metastatic breast cancer without a recognized primary breast lesion. We report a rare case of OBC that was detected laparoscopically. A 64-year-old female presented to our hospital with back pain. Magnetic resonance imaging (MRI) revealed a 50mm multicystic tumor with an internal nodule in the right ovary. Positron emission tomography/computed tomography showed abnormal accumulation in multiple lymph nodes, moderate accumulation in the ovarian tumor nodule, and no accumulation in the breasts. Ovarian cancer was suspected, and a diagnostic laparoscopy was performed. Laparoscopically, a cystic tumor in the right ovary and 10mm nodule in the right round ligament were observed and partially resected. Immunohistopathologically, the nodules of the round ligament exhibited features consistent with those of breast cancer, but the ovarian tumor was a seromucinous borderline tumor. MRI revealed no breast lesions. Therefore, the malignancy was diagnosed as an OBC.

• Platinum-based chemotherapy is the cornerstone of treatment for ovarian cancer. • Hypersensitivity reaction (HSR) is a serious adverse reaction of anticancer drugs with anaphylactic features. • HSR to platinum agents could lead to interruption of effective treatments for ovarian cancer, resulting in poor prognosis. • We presented a case of successful nedaplatin desensitization therapy with a history of HSR to carboplatin and nedaplatin. • The nedaplatin desensitization regimen could be an alternative for the patients with platinum sensitive ovarian cancer.