Department of Obstetrics and Gynecology, Service of Gynecology, Geneva University Hospitals, Geneva 14, Switzerland.
Expert Rev Anticancer Ther. 2010 Mar;10(3):451-60. doi: 10.1586/era.09.192.
Patients with early-stage cervical cancer may be treated appropriately with either radical surgery or radiation therapy. As most patients will be cured of their disease, side-effects of therapy and quality of life become of great importance. Individualization of treatment to reduce therapy-associated morbidity should be the main goal in cervical cancer management. Recent developments in surgical techniques, such as laparoscopy, nerve-sparing radical hysterectomy, sentinel lymph node biopsy, trachelectomy and 'less radical' hysterectomy, have contributed to reduce the morbidity of the surgical treatment. The use of postoperative radiotherapy or chemoradiation leads to more pronounced side effects than after either surgery or irradiation alone. Therefore, prognostic factors should be used to select patients for either surgery or radiotherapy alone to minimize the increased toxicities associated with the combination. The objectives of this review are to discuss the evidence supporting radical surgery, 'less radical' surgery and radiotherapy with regard to complication rate and quality of life.
早期宫颈癌患者可通过根治性手术或放射治疗进行适当治疗。由于大多数患者的疾病可以治愈，因此治疗的副作用和生活质量变得非常重要。减少与治疗相关的发病率应是宫颈癌管理的主要目标。手术技术的最新进展，如腹腔镜检查、保留神经的根治性子宫切除术、前哨淋巴结活检、子宫颈切除术和“不那么激进”的子宫切除术，有助于降低手术治疗的发病率。与单独手术或放疗相比，术后放疗或放化疗会导致更明显的副作用。因此，应使用预后因素来选择单独进行手术或放疗的患者，以最大限度地减少与联合治疗相关的毒性增加。本综述的目的是讨论支持根治性手术、“不那么激进”手术和放疗的证据，以评估其并发症发生率和生活质量。
