Table 1 Timeline of clinical course and interventions
Date | Clinical course and interventions |
|---|---|
March 2020 | Patient symptoms: stress incontinence. No relief after observation. |
November 2020 | Patient symptoms: right lower back pain. Diagnosis: cervical adenocarcinoma stage IVA. |
December 17, 2020- February 6, 2021 | Chemoembolization with cisplatin 90 mg/carboplatin 500 mg and paclitaxel 210 mg (the paient had tinnitus for seven years, so switch to chemotherapy). |
March 4- April 26, 2021 | Concurrent chemotherapy three cycles with carboplatin 210 mg. Radiotherapy: twenty-eight external irradiation and six afterloading. |
May 2021 | MRI: cervical mass, right obturator lymph node and left obturator lymph node were smaller than before, uterine cavity dilatation and vaginal wall thickening were less than before. Partial response of the patient’s condition. |
June 4- July 29, 2021 | Consolidation chemotherapy three cycles with carboplatin 450 mg, paclitaxel 210 mg and bevacizumab 400 mg. |
August 20- October 6, 2021 | Consolidation chemotherapy three cycles with carboplatin 450 mg, paclitaxel 210 mg, bevacizumab 400 mg and pembrolizumab 200 mg. |
October 8, 2021 | Patient symptoms: massive gross hematuria with visible blood clots. Chemotherapy stopped. |
November 8- December 1, 2021 | Symptomatic treatment: cefoxitin 2 g q8h ivgtt for anti-infective treatment, and tranexamic acid 1 g qd ivgtt and hemocoagulase 1unit q12h ivgtt for hemostasis and symptomatic treatment (23 days). Clinical improvement in 10 days. |
November 2021 | CT: mass soft tissue shadows were seen in bilateral adnexal areas, the size was about 3.9*2.1 cm, and the bladder wall was unevenly thickened, with a thickness of 2.6 cm. |
January 2022 | Patient symptoms: a small amount of bleeding from the urethral opening after defecation, and slight urinary incontinence. |
January 2022 | PT/CT imaging: no definite signs of tumor metastasis or recurrence in the body; increased distribution of 18 F-FDG in the posterior wall of the bladder, which does not rule out the possibility of blood clots or others; impaired right renal function. Stable disease of the patient’s condition. |