Skip to main content
SpringerLink
Log in

Treatment of Advanced and Recurrent Carcinoma: Chemotherapy

  • Chapter
  • First Online:
Book cover Uterine Cancer

Part of the book series: Current Clinical Oncology ((CCO))

  • 694 Accesses

Abstract

The development of chemotherapy in endometrial cancer took place over two decades, but finally drug combinations have convincingly been shown to have a role in the treatment of advanced and recurrent endometrial cancer. Agents with antitumor activity include doxorubicin, cisplatin, and paclitaxel. A combination of paclitaxel with the cisplatin analog carboplatin and the combination of the three drugs are currently the most commonly used regimens.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fleming GF, Brunetto VL, Cella D, et al. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 2004;22:2159–2166.

    Article  PubMed  CAS  Google Scholar 

  2. Fleming GF, Filiaci VL, Bentley RC, et al. Phase III randomized trial of doxorubicin + cisplatin versus doxorubicin + 24-h paclitaxel + filgrastim in endometrial carcinoma: a Gynecologic Oncology Group study. Ann Oncol 2004;15:1173–1178.

    Article  PubMed  CAS  Google Scholar 

  3. Sutton G, Brunetto VL, Kilgore L, et al. A phase III trial of ifosfamide with or without cisplatin in carcinosarcoma of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol 2000;79: 147–153.

    Article  PubMed  CAS  Google Scholar 

  4. Horton J, Begg CB, Arseneault J, Bruckner H, Creech R, Hahn RG. Comparison of adriamycin with cyclophosphamide in patients with advanced endometrial cancer. Cancer Treat Rep 1978;62:159–161.

    PubMed  CAS  Google Scholar 

  5. Thigpen JT, Buchsbaum HJ, Mangan C, Blessing JA. Phase II trial of adriamycin in the treatment of advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. Cancer Treat Rep 1979;63:21–27.

    PubMed  CAS  Google Scholar 

  6. Burke TW, Munkarah A, Kavanagh JJ, et al. Treatment of advanced or recurrent endometrial carcinoma with single-agent carboplatin. Gynecol Oncol 1993;51:397–400.

    Article  PubMed  CAS  Google Scholar 

  7. Edmonson JH, Krook JE, Hilton JF, et al. Randomized phase II studies of cisplatin and a combination of cyclophosphamide-doxorubicin-cisplatin (CAP) in patients with progestin-refractory advanced endometrial carcinoma. Gynecol Oncol 1987;28:20–24.

    Article  PubMed  CAS  Google Scholar 

  8. Green JB, 3rd, Green S, Alberts DS, O’Toole R, Surwit EA, Noltimier JW. Carboplatin therapy in advanced endometrial cancer. Obstet Gynecol 1990;75:696–700.

    PubMed  Google Scholar 

  9. Seski JC, Edwards CL, Herson J, Rutledge FN. Cisplatin chemotherapy for disseminated endometrial cancer. Obstet Gynecol 1982;59:225–228.

    PubMed  CAS  Google Scholar 

  10. Thigpen JT, Blessing JA, Homesley H, Creasman WT, Sutton G. Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 1989;33:68–70.

    Article  PubMed  CAS  Google Scholar 

  11. Trope C, Grundsell H, Johnsson JE, Cavallin-Stahl E. A phase II study of Cis-platinum for recurrent corpus cancer. Eur J Cancer 1980;16:1025–1026.

    Article  PubMed  CAS  Google Scholar 

  12. van Wijk FH, Lhomme C, Bolis G, et al. Phase II study of carboplatin in patients with advanced or recurrent endometrial carcinoma. A trial of the EORTC Gynaecological Cancer Group. Eur J Cancer 2003;39:78–85.

    Article  PubMed  CAS  Google Scholar 

  13. Gunthert AR, Ackerman S, Beckmann MW et al. Phase II study of weekly docetaxel in patients with recurrent or metastatic endometrial cancer: AGO Uterus-4. Gynecol Oncol 2007;104:86–90.

    Article  PubMed  CAS  Google Scholar 

  14. Katsumata N, Noda K, Nozawa S, et al. Phase II trial of docetaxel in advanced or metastatic endometrial cancer: a Japanese Cooperative Study. Br J Cancer 2005;93:999–1004.

    Article  PubMed  CAS  Google Scholar 

  15. Lincoln S, Blessing JA, Lee RB, Rocereto TF. Activity of paclitaxel as second-line chemotherapy in endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2003;88:277–281.

    Article  PubMed  CAS  Google Scholar 

  16. Lissoni A, Zanetta G, Losa G, Gabriele A, Parma G, Mangioni C. Phase II study of paclitaxel as salvage treatment in advanced endometrial cancer. Ann Oncol 1996;7:861–863.

    PubMed  CAS  Google Scholar 

  17. Carbone PP, Carter SK. Endometrial cancer: approach to development of effective chemotherapy. Gynecol Oncol 1974;2:348–353.

    Article  PubMed  CAS  Google Scholar 

  18. Miller DS, Blessing JA, Lentz SS, Waggoner SE. A phase II trial of topotecan in patients with advanced, persistent, or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2002;87:247–251.

    Article  PubMed  CAS  Google Scholar 

  19. Pawinski A, Tumolo S, Hoesel G, et al. Cyclophosphamide or ifosfamide in patients with advanced and/or recurrent endometrial carcinoma: a randomized phase II study of the EORTC Gynecological Cancer Cooperative Group. Eur J Obstet Gynecol Reprod Biol 1999;86: 179–183.

    Article  PubMed  CAS  Google Scholar 

  20. Wadler S, Levy DE, Lincoln ST, Soori GS, Schink JC, Goldberg G. Topotecan is an active agent in the first-line treatment of metastatic or recurrent endometrial carcinoma: Eastern Cooperative Oncology Group Study E3E93. J Clin Oncol 2003;21:2110–2114.

    Article  PubMed  Google Scholar 

  21. Thigpen JT, Brady MF, Homesley HD, et al. Phase III trial of doxorubicin with or without cisplatin in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 2004;22:3902–3908.

    Article  PubMed  CAS  Google Scholar 

  22. Aapro MS, van Wijk FH, Bolis G, et al. Doxorubicin versus doxorubicin and cisplatin in endometrial carcinoma: definitive results of a randomised study (55872) by the EORTC Gynaecological Cancer Group. Ann Oncol 2003;14:441–448.

    Article  PubMed  CAS  Google Scholar 

  23. Hoskins PJ, Swenerton KD, Pike JA, et al. Paclitaxel and carboplatin, alone or with irradiation, in advanced or recurrent endometrial cancer: a phase II study. J Clin Oncol 2001;19:4048–4053.

    PubMed  CAS  Google Scholar 

  24. Nakamura T, Onishi Y, Yamamoto F, Kouno S, Maeda Y, Hatae M. Evaluation of paclitaxel and carboplatin in patients with endometrial cancer. Gan To Kagaku Ryoho 2000;27:257–262.

    PubMed  CAS  Google Scholar 

  25. Price FV, Edwards RP, Kelley JL, Kunschner AJ, Hart LA. A trial of outpatient paclitaxel and carboplatin for advanced, recurrent, and histologic high-risk endometrial carcinoma: preliminary report. Semin Oncol 1997;24:S15–78–S15–82.

    PubMed  CAS  Google Scholar 

  26. Scudder SA, Liu PY, Wilczynski SP, et al. Paclitaxel and carboplatin with amifostine in advanced, recurrent, or refractory endometrial adenocarcinoma: a phase II study of the Southwest Oncology Group. Gynecol Oncol 2005;96:610–615.

    Article  PubMed  CAS  Google Scholar 

  27. Weber B, Mayer F, Bougnoux P, et al. What is the best chemotherapy regimen in recurrent or advanced endometrial carcinoma? Preliminary results. Paper presented at: Proc Am Soc Clin Oncol, 2003.

    Google Scholar 

  28. Randall ME, Brunetto G, Muss H, et al. Whole abdominal radiotherapy versus combination doxorubicin-cisplatin chemotherapy in advanced endometrial carcinoma: a randomized phase III trial of the Gynecologic Oncology Group. Paper presented at: Proc Am Soc Clin Oncol, 2003.

    Google Scholar 

  29. Maggi R, Lissoni A, Spina F, et al. Adjuvant chemotherapy vs radiotherapy in high-risk endometrial carcinoma: results of a randomised trial. Br J Cancer 2006;95:266–271.

    Article  PubMed  CAS  Google Scholar 

  30. Greven K, Winter K, Underhill K, Fontenesci J, Cooper J, Burke T. Preliminary analysis of RTOG 9708: Adjuvant postoperative radiotherapy combined with cisplatin/paclitaxel chemotherapy after surgery for patients with high-risk endometrial cancer. Int J Radiat Oncol Biol Phys 2004;59:168–173.

    Article  PubMed  Google Scholar 

  31. Dinh TV, Slavin RE, Bhagavan BS, Hannigan EV, Tiamson EM, Yandell RB. Mixed mullerian tumors of the uterus: a clinicopathologic study. Obstet Gynecol 1989;74:388–392.

    PubMed  CAS  Google Scholar 

  32. George M, Pejovic MH, Kramar A. Uterine sarcomas: prognostic factors and treatment modalities--study on 209 patients. Gynecol Oncol 1986;24:58–67.

    Article  PubMed  CAS  Google Scholar 

  33. Gershenson DM, Kavanagh JJ, Copeland LJ, Edwards CL, Freedman RS, Wharton JT. High-dose doxorubicin infusion therapy for disseminated mixed mesodermal sarcoma of the uterus. Cancer 1987;59:1264–1267.

    Article  PubMed  CAS  Google Scholar 

  34. Omura GA, Major FJ, Blessing JA, et al. A randomized study of adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas. Cancer 1983;52: 626–632.

    Article  PubMed  CAS  Google Scholar 

  35. Thigpen JT, Blessing JA, Orr JW, Jr, DiSaia PJ. Phase II trial of cisplatin in the treatment of patients with advanced or recurrent mixed mesodermal sarcomas of the uterus: a Gynecologic Oncology Group study. Cancer Treat Rep 1986;70:271–274.

    PubMed  CAS  Google Scholar 

  36. Thigpen JT, Kronmal R, Vogel S, et al. A phase II trial of vinblastine in patients with advanced or recurrent endometrial carcinoma. A Southwest Oncology Group Study. Am J Clin Oncol 1987;10:429–431.

    Article  PubMed  CAS  Google Scholar 

  37. Curtin JP, Blessing JA, Soper JT, DeGeest K. Paclitaxel in the treatment of carcinosarcoma of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol 2001;83:268–270.

    Article  PubMed  CAS  Google Scholar 

  38. Sutton GP, Blessing JA, Rosenshein N, Photopulos G, DiSaia PJ. Phase II trial of ifosfamide and mesna in mixed mesodermal tumors of the uterus (a Gynecologic Oncology Group study). Am J Obstet Gynecol 1989;161:309–312.

    PubMed  CAS  Google Scholar 

  39. Homesley HD, Filiaci VL, Bitterman P, et al. Phase III trial of ifosfamide plus paclitaxel as first line of advanced or recurrent uterine carcinosarcoma (mixed mesodermal tumors). Gynecol Oncol 2006;101:S31.

    Google Scholar 

  40. Wolfsen AH, Brady MF, Rocereto T, et al. A gynecologic oncology group randomized phase III trial of whole abdominal irradiation (WAI) vs Cisplatin-Ifosfamide and mesna (CIM) as Post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus. Gynecol Oncol 2007; 107(2):177–185 PMID 17822748.

    Article  Google Scholar 

  41. Jasa KV, Fyles A, Elit L, et al. Phase II study of erlotinib (OSI 774) in women with recurrent or metastatic or metastatic endometrial cancer: NCIC CTG IND-148. Paper presented at ASCO, 2004.

    Google Scholar 

  42. Grushko TA, Ridderstrale K, Olopade OI, Mundt A, Fleming GF. Identification of HER-2/NEU oncogene amplification by fluorescence in situ hybridization in endometrial carcinoma from patients included in Gynecologic Oncology Group trial. Proc Am Soc Clin Oncol 2003;22:468.

    Google Scholar 

  43. Villella JA, Cohen S, Tiersten A, Smith DH, Hibshoosh H, Hershman D. Her2/neu expression in uterine papillary serous cancers. Proc Am Soc Clin Oncol 2003;22:465.

    Google Scholar 

  44. Fleming GF, Sill MA, Thigpen JT, et al. Phase II evaluation of trastuzumab in patients with advanced or recurrent endometrial carcinoma: a report on GOG 181B. Proc Am Soc Clin Oncol 2003;22:453.

    Google Scholar 

  45. Slomovitz BM, Wu W, Broaddus RR, et al. mTOR inhibition is a rational target for the treatment of endometrial cancer. J Clin Oncol 2004:22.

    Google Scholar 

  46. Oza AM, Elit L, Biagi J, et al. A phase II study of Temisrolimus (CCI-779) in Patients patients with Metastatic metastatic and/or Locally locally Recurrent recurrent Endometrial endometrial Cancer cancer - NCIC CTG IND 160. Paper presented at: AACR-NCI-EORTC Molecular Targets and Cancer Therapeutics, 2005.

    Google Scholar 

  47. Fracasso PM, Blessing JA, Molpus KL, Adler LM, Sorosky J, Rose PG. Phase II study of oxiliplatin as second-line chemotherapy in endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2006;103:523–26.

    Article  PubMed  CAS  Google Scholar 

  48. Calero F, Asins-Codoner E, Jimeno J, et al. Epirubicin in advanced endometrial adenocarcinoma: a phase II study of the Grupo Ginecologico Espanol para el Tratamiento Oncologico (GGETO). Eur J Cancer 1991;27:864–866.

    Article  PubMed  CAS  Google Scholar 

  49. Homesley HD, Blessing JA, Sorosky J, Reid G, Look KY. Phase II trial of liposomal doxorubicin at 40 mg/m(2) every 4 weeks in endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2005;98:294–298.

    Article  PubMed  CAS  Google Scholar 

  50. Ball HG, Blessing JA, Lentz SS, Mutch DG. A phase II trial of paclitaxel in patients with advanced or recurrent adenocarcinoma of the endometrium: a Gynecologic Oncology Group study. Gynecol Oncol 1996;62:278–281.

    Article  PubMed  CAS  Google Scholar 

  51. Hirai Y, Hasumi K, Onose R, et al. Phase II trial of 3-h infusion of paclitaxel in patients with adenocarcinoma of endometrium: Japanese Multicenter Study Group. Gynecol Oncol 2004;94:471–476.

    Article  PubMed  CAS  Google Scholar 

  52. Seski JC, Edwards CL, Copeland LJ, Gershenson DM. Hexamethylmelamine chemotherapy for disseminated endometrial cancer. Obstet Gynecol 1981;58:361–363.

    PubMed  CAS  Google Scholar 

  53. Thigpen JT, Blessing JA, Ball H, Hanjani P, Manetta A, Homesley H. Hexamethylmelamine as first-line chemotherapy in the treatment of advanced or recurrent carcinoma of the endometrium: a phase II trial of the Gynecologic Oncology Group. Gynecol Oncol 1988;31: 435–438.

    Article  PubMed  CAS  Google Scholar 

  54. Barton C, Buxton EJ, Blackledge G, Mould JJ, Meanwell CA. A phase II study of ifosfamide in endometrial cancer. Cancer Chemother Pharmacol 1990;26(Suppl):S4–S6.

    Article  PubMed  Google Scholar 

  55. Sutton GP, Blessing JA, DeMars LR, et al. A phase II Gynecologic Oncology Group trial of ifosfamide and mesna in advanced or recurrent adenocarcinoma of the endometrium. Gynecol Oncol 1996;63:25–27.

    Article  PubMed  CAS  Google Scholar 

  56. Broun GO, Blessing JA, Eddy GL, Adelson MD. A phase II trial of vincristine in advanced or recurrent endometrial carcinoma. A Gynecologic Oncology Group study. Am J Clin Oncol 1993;16:18–21.

    Article  PubMed  CAS  Google Scholar 

  57. Muss HB, Blessing JA, Hatch KD, Soper JT, Webster KD, Kemp GM. Methotrexate in advanced endometrial carcinoma. A phase II trial of the Gynecologic Oncology Group. Am J Clin Oncol 1990;13:61–63.

    Article  PubMed  CAS  Google Scholar 

  58. Poplin EA, Liu PY, Delmore JE, et al. Phase II trial of oral etoposide in recurrent or refractory endometrial adenocarcinoma: a Southwest Oncology Group Study. Gynecol Oncol 1999;74: 432–435.

    Article  PubMed  CAS  Google Scholar 

  59. Hilgers RD, Von Hoff DD, Stephens RL, Boutselis JG, Rivkin SE. Mitoxantrone in adenocarcinoma of the endometrium: a Southwest Oncology Group Study. Cancer Treat Rep 1985;69: 1329–1330.

    PubMed  CAS  Google Scholar 

  60. Muggia FM, Blessing JA, Sorosky J, Reid GC. Phase II trial of the pegylated liposomal doxorubicin in previously treated metastatic endometrial cancer: a Gynecologic Oncology Group study. J Clin Oncol 2002;20:2360–2364.

    Article  PubMed  CAS  Google Scholar 

  61. Woo HL, Swenerton KD, Hoskins PJ. Taxol is active in platinum-resistant endometrial adenocarcinoma. Am J Clin Oncol 1996;19:290–291.

    Article  PubMed  CAS  Google Scholar 

  62. Deppe G, Cohen CJ, Bruckner HW. Treatment of advanced endometrial adenocarcinoma with cis-dichlorodiammine platinum (II) after intensive prior therapy. Gynecol Oncol 1980;10: 51–54.

    Article  PubMed  CAS  Google Scholar 

  63. Thigpen JT, Blessing JA, Lagasse LD, DiSaia PJ, Homesley HD. Phase II trial of cisplatin as second-line chemotherapy in patients with advanced or recurrent endometrial carcinoma. A Gynecologic Oncology Group study. Am J Clin Oncol 1984;7:253–256.

    Article  PubMed  CAS  Google Scholar 

  64. Sutton GP, Blessing JA, Homesley HD, McGuire WP, Adcock L. Phase II study of ifosfamide and mesna in refractory adenocarcinoma of the endometrium. A Gynecologic Oncology Group study. Cancer 1994;73:1453–1455.

    Article  PubMed  CAS  Google Scholar 

  65. Slayton RE, Blessing JA, Delgado G. Phase II trial of etoposide in the management of advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. Cancer Treat Rep 1982;66:1669–1671.

    PubMed  CAS  Google Scholar 

  66. Muss HB, Bundy BN, Adcock L. Teniposide (VM-26) in patients with advanced endometrial carcinoma. A phase II trial of the Gynecologic Oncology Group. Am J Clin Oncol 1991;14: 36–37.

    Article  PubMed  CAS  Google Scholar 

  67. Rose PG, Blessing JA, Lewandowski GS, Creasman WT, Webster KD. A phase II trial of prolonged oral etoposide (VP-16) as second-line therapy for advanced and recurrent endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 1996;63:101–104.

    Article  PubMed  CAS  Google Scholar 

  68. Jackson DV Jr., Jobson VW, Homesley HD, et al. Vincristine infusion in refractory gynecologic malignancies. Gynecol Oncol 1986;25:212–216.

    Article  PubMed  Google Scholar 

  69. Von Hoff DD, Green S, Alberts DS, et al. Phase II study of fludarabine phosphate (NSC-312887) in patients with advanced endometrial cancer. A Southwest Oncology Group Study. Am J Clin Oncol 1991;14:193–194.

    Article  PubMed  CAS  Google Scholar 

  70. Moore DH, Blessing JA, Dunton C, Buller RE, Reid GC. Dactinomycin in the treatment of recurrent or persistent endometrial carcinoma: a Phase II study of the Gynecologic Oncology Group. Gynecol Oncol 1999;75:473–475.

    Article  PubMed  CAS  Google Scholar 

  71. Thigpen JT, Blessing JA, DiSaia PJ, Yordan E, Carson LF, Evers C. A randomized comparison of doxorubicin alone versus doxorubicin plus cyclophosphamide in the management of advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 1994;12:1408–1414.

    PubMed  CAS  Google Scholar 

  72. Gallion HH, Brunetto VL, Cibull M, et al. Randomized phase III trial of standard timed doxorubicin plus cisplatin versus circadian timed doxorubicin plus cisplatin in stage III and IV or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 2003;21:3808–3813.

    Article  PubMed  CAS  Google Scholar 

  73. Dimopoulos MA, Papadimitriou CA, Georgoulias V, et al. Paclitaxel and cisplatin in advanced or recurrent carcinoma of the endometrium: long-term results of a phase II multicenter study. Gynecol Oncol 2000;78:52–57.

    Article  PubMed  CAS  Google Scholar 

  74. Gebbia V, Testa A, Borsellino N, Ferrera P, Tirrito M, Palmeri S. Cisplatin and vinorelbine in advanced and/or metastatic adenocarcinoma of the endometrium: a new highly active chemotherapeutic regimen. Ann Oncol 2001;12:767–772.

    Article  PubMed  CAS  Google Scholar 

  75. Susumu N, Sagae S, Udagawa Y, Niwak, Kuramoto H, Satch S, Kudo R. Randomized phase III trial of pelvic radiotherapy versus asplatin-based combined chemotherapy in patients with intermediatic - and high - risk endometrial cancer: A Japanese Gynecologic Oncology Group study. Gynecol Oncel 2008;108:226–233.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Hematology/Oncology, Department of Medicine, University of Chicago Medical Center, Chicago, IL

    Halla Nimeiri & Gini F. Fleming

Authors
  1. Halla Nimeiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gini F. Fleming
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

    Rights and permissions

    Reprints and permissions

    Copyright information

    © 2009 Humana Press, a part of Springer Science+Business Media, LLC

    About this chapter

    Cite this chapter

    Nimeiri, H., Fleming, G.F. (2009). Treatment of Advanced and Recurrent Carcinoma: Chemotherapy. In: Oliva, E., Muggia, F. (eds) Uterine Cancer. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-60327-044-1_12

    Download citation

    • DOI: https://doi.org/10.1007/978-1-60327-044-1_12

    • Published:

    • Publisher Name: Humana Press

    • Print ISBN: 978-1-58829-736-5

    • Online ISBN: 978-1-60327-044-1

    • eBook Packages: MedicineMedicine (R0)

    Publish with us

    Policies and ethics

    Search

    Navigation