Book contents
- Gynaecological Oncology for the MRCOG
- Gynaecological Oncology for the MRCOG
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Abbreviations
- 1 Epidemiology of Gynaecological Cancers
- 2 Pathology of Gynaecological Cancers
- 3 Imaging in Gynaecological Oncology
- 4 Concepts of Treatment Approaches in Gynaecological Oncology
- 5 Radiation Therapy for Gynaecological Malignancies
- 6 Systemic Therapy in Gynaecological Cancers
- 7 Preinvasive Disease, Screening and Hereditary Cancer
- 8 Surgical Principles in Gynaecological Oncology
- 9 Role of Laparoscopic Surgery
- 10 Ovarian, Fallopian Tube and Primary Peritoneal Cancer (including Borderline)
- 11 Endometrial Cancer
- 12 Cervical and Vaginal Cancer
- 13 Vulval Cancer
- 14 Uterine Sarcomas
- 15 Non-epithelial Ovarian Tumours and Gestational Trophoblastic Neoplasia
- 16 Palliative Care
- 17 Living with Cancer
- 18 Communication in Gynaecological Oncology
- Appendix
- Index
Appendix
Published online by Cambridge University Press: 14 April 2018
- Gynaecological Oncology for the MRCOG
- Gynaecological Oncology for the MRCOG
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Abbreviations
- 1 Epidemiology of Gynaecological Cancers
- 2 Pathology of Gynaecological Cancers
- 3 Imaging in Gynaecological Oncology
- 4 Concepts of Treatment Approaches in Gynaecological Oncology
- 5 Radiation Therapy for Gynaecological Malignancies
- 6 Systemic Therapy in Gynaecological Cancers
- 7 Preinvasive Disease, Screening and Hereditary Cancer
- 8 Surgical Principles in Gynaecological Oncology
- 9 Role of Laparoscopic Surgery
- 10 Ovarian, Fallopian Tube and Primary Peritoneal Cancer (including Borderline)
- 11 Endometrial Cancer
- 12 Cervical and Vaginal Cancer
- 13 Vulval Cancer
- 14 Uterine Sarcomas
- 15 Non-epithelial Ovarian Tumours and Gestational Trophoblastic Neoplasia
- 16 Palliative Care
- 17 Living with Cancer
- 18 Communication in Gynaecological Oncology
- Appendix
- Index
Summary
WHO Performance Status Classification
Performance status is frequently used to quantify cancer patients’ well-being and often used to indicate whether or not a patient can tolerate certain treatment such as chemotherapy. Other uses include dose reduction, use in trial and quality of life.
Grade Explanation of activity
0: Able to carry out all normal activity without restriction
1: Restricted in physically strenuous activity, but ambulatory and able to carry out light work
2: Ambulatory and capable of all self-care, but unable to carry out work; up and about more than 50% of waking hours
3: Capable only of limited self-care; confined to bed more than 50% of waking hours
4: Completely disabled; cannot carry out any self-care; totally confined to bed or chair
Criteria of chemotherapy response (WHO)
• Complete response (CR) – resolution of all measureable or evaluable disease
• Partial response (PR) – ≥50% reduction in measureable or evaluable disease in the absence of progression in any particular disease site
• Stable disease (SD) – <50% decrease or <25% increase in measureable or evaluable disease
• Progressive disease (PD) – >25% increase in measureable or evaluable disease or development of a new lesion
Clinical Trials and Drug Development
Clinical trials are divided into different stages, called phases. The earliest phase trials may look at drug safety or side-effect profile and tolerability. A later phase trial aims to test whether a new treatment is better than existing treatments.
There are three main phases of clinical trials – phases I to III. But some trials have an earlier stage called phase 0, and there are some phase IV trials done after a drug has been licensed.
Phase 0 Trials
Phase 0 trials are aimed to find out whether the behaviour of the drug in vivo is as expected from laboratory studies.
Phase I
Aim is to establish human toxicity of new drug; to establish the safe dose at which to start further trials and to measure the pharmacokinetics of the drug.
Phase II
Aim is to establish the anti-tumour activity of the drug against a particular tumour in patients where no curative therapy is possible; further information on toxicity is obtained. Phase II studies are usually non-randomised.
Phase III
Aim is to compare the new drug with the conventional best therapy. Trials are prospective, randomised and controlled. Large number of patients required to show effect.
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- Gynaecological Oncology for the MRCOG , pp. 197 - 206Publisher: Cambridge University PressPrint publication year: 2018