台灣婦癌醫學會 Taiwan Association of Gynecologic Oncologists

                                                        本期編輯 陳子健 醫師   

壹、 會務報告

<一> 理事長致詞

   首先，感謝前任周振陽理事長以及黃順賢秘書長對學會的貢獻與付出。在未來的兩年任期中，請謝長堯前理事長及楊育正前理事長繼續指導及協助，讓學會的會務更加蓬勃發展。

   本學會的專科醫師甄審制度，已備受其他學會的重視與學習。未來將進一步規劃對於已考過專科醫師證書的會員之重新審核（民國100年換證）。對於準會員的教育訓練，擬規劃做一季一次的整日訓練，並每年各準會員要報告自己年度訓練狀況，詳細辦法請教育委員會召集人協助進行。此外，也將藉由會刊及網路，加強對會員的服務與聯繫，擴大活動的參與。       

<二> 理監事會報告

@ 第六屆理監事名單

理事會

理 事 長：王功亮

常務理事：陳祈安、張廷彰、葉聯舜、顏明賢

理    事：楊育正、周振陽、何志明、張簡展照、謝長堯、余慕賢、周宏學、何

          師竹、朱堂元、簡婉儀

候補理事：林鈺山、黃寬仁、林隆堯

監事會

常務監事：鄭文芳

監    事：李耀泰、鄭雅敏、黃順賢、黃莉文

候補監事：周松男

@ 目前會員狀況（共計129人）【至97.07.17】

@ 未來一年活動規劃

<三>  近期學會活動

北區婦癌學術研討會

時 間： 民國9 7 年0 8 月0 9 日（ 週六） 0 9 : 3 0 ~ 1 5: 0 0

地 點： 馬偕紀念醫院淡水院區安寧病房4 F 會議室

主辦單位： 台灣婦癌醫學會、中華民國婦癌醫學會、馬偕紀念醫院

內容:

(1)Advances in the management of gynecologic cancers, ASCO 2008 update (國泰綜合醫院婦癌中心主任何志明醫師）

(2)Cervarix update (嘉義長庚醫院婦產科主任 曾志仁醫師)

(3)Recent advance in the treatment of recurrent ovarian cancer：A focus on weekly Topotecan (高雄榮民總醫院婦科主任 劉文雄醫師)

(4)安寧感性與靈性之旅 (安寧療護教育示範中心第一任醫療主任 賴允亮醫師）

(5)Laparoscopic radical hysterectomy in early cervical cancer (林口長庚醫院婦產部主任李奇龍醫師）

(6)Laparoscopic pelvic & para-aortic lymphadenectomy (台灣婦癌醫學會理事長及中華民國婦癌醫學會理事長王功亮醫師）

(7)The role of laparoscopic surgery in endometrial cancer (台灣婦產科內視鏡暨微創醫學會理事長林武周醫師）

(8)Discussion (Laparoscopic surgery in gynecologic cancer)

精采充實的演講與討論，將於近日內呈現於學會網頁　＂會員服務區＂裡的　＂線上會議＂當中。

貳、 會員動態及意見與回應

(歡迎提供會員動態與意見（學會E-mail address: tago.gyn@gmail.com)

＠　王功亮理事長於民國9 7 年0 8 月16 日榮任馬偕紀念醫院婦產部主任。

＠　劉文雄醫師榮任高雄榮總癌症中心主任。

参、 前月文獻選錄

＠　Cervical neoplasia in pregnancy. Part 1: screening and management of preinvasive disease.

(Am J Obstet Gynecol. 2008 Jul;199(1):3-9. Hunter MI, Monk BJ, Tewari KS. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of California, Irvine, Irvine, CA 92868, USA.)
  In the present review, current guidelines regarding cervical cancer screening are reviewed, and data from studies of pregnant populations are summarized.

＠　Cervical neoplasia in pregnancy. Part 2: current treatment of invasive disease.
(Am J Obstet Gynecol. 2008 Jul;199(1):10-8. Hunter MI, Tewari K, Monk BJ. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of California, Irvine, Irvine, CA, USA.)
  Although the treatment of cervical cancer has evolved under the drive of multicenter, randomized trials, the same level of evidence does not exist for the treatment of this malignancy in pregnancy. Treatment algorithms are therefore proposed as a series of modifications to the guidelines intended for the nonpregnant patient, taking into account the tremendous social, ethical, and emotional dilemmas specific to each trimester at presentation.

Efficacy of letrozole in the treatment of recurrent platinum- and taxane-resistant high-grade cancer of the ovary or peritoneum.
(Gynecol Oncol. 2008 Jul;110(1):56-9. Ramirez PT, Schmeler KM, Milam MR, Slomovitz BM, Smith JA, Kavanagh JJ, Deavers M, Levenback C, Coleman RL, Gershenson DM. Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston)
  A single-institution, phase II study was performed in women with recurrent ER+ epithelial carcinoma of the ovary or peritoneum. Letrozole was administered at a dose of 2.5 mg orally once daily until disease progression or toxicity occurred. 26% derived a clinical benefit (SD and PR). The most common adverse effects were fatigue (36%) and diaphoresis (21%). No grade 3 or 4 toxicities were reported.

Phase II evaluation of imatinib mesylate in the treatment of recurrent or persistent epithelial ovarian or primary peritoneal carcinoma: a Gynecologic Oncology Group Study.
(J Clin Oncol. 2008 Jul 10;26(20):3418-25. Schilder RJ, Sill MW, Lee RB, Shaw TJ, Senterman MK, Klein-Szanto AJ, Miner Z, Vanderhyden BC. Department of Medical Oncology, Fox Chase Cancer Center, USA. )
  This phase II trial assessed the activity and tolerability of an oral dose of imatinib mesylate 400 mg twice daily in patients with recurrent or persistent epithelial ovarian or primary peritoneal carcinoma. Fifty-six eligible patients were evaluated. Nine patients were progression free for at least 6 months including one complete responder. The median PFS and survival were 2 and 16 months, respectively. Imatinib mesylate was well tolerated but had minimal single-agent activity.

Nonplatinum topotecan combinations versus topotecan alone for recurrent ovarian cancer: results of a phase III study of the North-Eastern German Society of Gynecological Oncology Ovarian Cancer Study Group.
(J Clin Oncol. 2008 Jul 1;26(19):3176-82. Sehouli J, Stengel D, Oskay-Oezcelik G, Zeimet AG, Sommer H, Klare P, Stauch M, Paulenz A, Camara O, Keil E, Lichtenegger W. Department of Gynecology,Charité University Medical Center, Berlin, Germany.)
  Women with relapsed ovarian cancer after primary surgery and platinum-based chemotherapy were randomly assigned to topotecan monotherapy 1.25 mg/m(2)/d, topotecan 1.0 mg/m(2) plus oral etoposide 50 mg/d, or topotecan 0.5 mg/m(2)/d plus gemcitabine 800 mg/m(2) on day 1 and 600 mg/m(2) on day 8 every 3 weeks. Nonplatinum topotecan combinations do not provide a survival advantage over topotecan alone in women with relapsed ovarian cancer.

Paclitaxel, epirubicin, and carboplatin in advanced or recurrent endometrial carcinoma: a Hellenic Co-operative Oncology Group (HeCOG) study.
(Gynecol Oncol. 2008 Jul;110(1):87-92. Papadimitriou CA, Bafaloukos D, Bozas G, Kalofonos H, Kosmidis P, Aravantinos G, Fountzilas G, Dimopoulos MA; Hellenic Co-operative Oncology Group. Department of Clinical Therapeutics, Alexandra Hospital, University of Athens School of Medicine, Athens, Greece.)

Sixty-three consecutive patients were treated on an outpatient basis with epirubicin 50 mg/m(2), followed by paclitaxel 150 mg/m(2), administered intravenously over a 3-h period. Subsequently, the patients received carboplatin at AUC of 5. The chemotherapy was repeated every 3 weeks with granulocyte colony-stimulating factor (G-CSF) support for a maximum of six courses. Thirty-six (63.2%) patients achieved objective clinical response (95% CI, 50.6-75.7%) including 14 (24.6%) complete and 22 (38.6%) partial responses. The median duration of response was 7.9 months, and the median times to progression and survival for all patients were 7.8 and 13.8 months, respectively. Grade 3 or 4 neutropenia occurred in 9 (15.5%) patients but only 3 episodes of neutropenic fever were encountered. Grade 2 or 3 neurotoxicity was observed in 19% of patients. Two patients died of sudden cardiac death 10 and 14 days after the administration of the first chemotherapy cycle, respectively, but these deaths were not clearly treatment related.

Treatment of vulvar intraepithelial neoplasia with topical imiquimod.
(N Engl J Med. 2008 Apr 3;358(14):1465-73. Comment in:N Engl J Med. 2008 Jul 3;359(1):93-4; author reply 94-5. van Seters M, van Beurden M, ten Kate FJ, Beckmann I, Ewing PC, Eijkemans MJ, Kagie MJ, Meijer CJ, Aaronson NK, Kleinjan A, Heijmans-Antonissen C, Zijlstra FJ, Burger MP, Helmerhorst TJ.Department of Gynecology, Erasmus University Medical Center, Rotterdam, The Netherlands.)
   Fifty-two patients with grade 2 or 3 vulvar intraepithelial neoplasia were randomly assigned to receive either imiquimod 5% cream or placebo, applied twice weekly for 16 weeks. Lesion size was reduced by more than 25% at 20 weeks in 21 of the 26 patients (81%) treated with imiquimod and in none of those treated with placebo (P<0.001). HPV cleared from the lesion in 15 patients in the imiquimod group (58%), as compared with 2 in the placebo group (8%) (P<0.001). Imiquimod reduced pruritus and pain at 20 weeks (P=0.008 and P=0.004, respectively) and at 12 months (P=0.04 and P=0.02, respectively). The lesion progressed to invasion (to a depth of <1 mm) in 3 of 49 patients (6%) followed for 12 months (2 in the placebo group and 1 in the imiquimod group). Nine patients, all treated with imiquimod, had a complete response at 20 weeks and remained free from disease at 12 months.

Management of depression for people with cancer (SMaRT oncology 1): a randomised trial.
(Lancet. 2008 Jul 5;372(9632):40-8. Comment in: Lancet. 2008 Jul 5;372(9632):8-10.
Strong V, Waters R, Hibberd C, Murray G, Wall L, Walker J, McHugh G, Walker A, Sharpe M.University of Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, UK.)
  The intervention-Depression Care for People with Cancer-offers a model for the management of major depressive disorder in patients with cancer and other medical disorders who are attending specialist medical services that is feasible, acceptable, and potentially cost effective.