Engleman Mark A, Small William
Department of Radiation Oncology, Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA.
Semin Oncol. 2003 Aug;30(4 Suppl 9):80-94. doi: 10.1016/s0093-7754(03)00275-6.
During the last several years, combined modality therapy has become increasingly important in the treatment of several malignancies. This trend holds true in the treatment of the gynecologic malignancies. In this review we examine the evolving role of combined modality therapy in the treatment of patients with cervical, vulvar, endometrial, and ovarian cancers. Definitive combined chemoradiation has become the new standard of care for patients with locally advanced cervical cancer. Combined chemoradiation provides for improvements in many clinical endpoints, including overall and disease-free survival. Chemoradiation has been used with some success in the treatment of patients with locally advanced vulvar carcinoma and has allowed some patients to avoid disfiguring surgery. Combined chemoradiation is being used in the treatment of patients with endometrial cancer who are found to be at high risk of recurrence after hysterectomy. In the setting of ovarian cancer, abdominopelvic radiation, either with or without chemotherapy, has shown some promise in the treatment of patients with minimal residual disease after resection. Combined modality therapy has played an increasingly important role in the treatment of gynecologic malignancies and its role continues to evolve and expand.
在过去几年中，综合治疗在多种恶性肿瘤的治疗中变得越来越重要。这种趋势在妇科恶性肿瘤的治疗中也同样适用。在本综述中，我们探讨了综合治疗在宫颈癌、外阴癌、子宫内膜癌和卵巢癌患者治疗中不断演变的作用。对于局部晚期宫颈癌患者，确定性同步放化疗已成为新的标准治疗方法。同步放化疗在许多临床终点方面都有改善，包括总生存期和无病生存期。同步放化疗在局部晚期外阴癌患者的治疗中已取得一定成功，并使一些患者避免了毁容性手术。同步放化疗正用于子宫切除术后复发风险高的子宫内膜癌患者的治疗。在卵巢癌方面，腹部盆腔放疗，无论是否联合化疗，在切除术后残留病灶极少的患者治疗中已显示出一些前景。综合治疗在妇科恶性肿瘤的治疗中发挥着越来越重要的作用，其作用也在不断演变和扩展。
