Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
J Gynecol Oncol. 2013 Jan;24(1):66-82. doi: 10.3802/jgo.2013.24.1.66. Epub 2013 Jan 8.
Ten topics were chosen among major clinical research achievements in gynecologic oncology in 2012. For ovarian cancer, comprehensive review of the history of bevacizumab studies was followed by poly adenosine diphosphate [ADP]-ribose polymerase (PARP) inhibitors and other molecular targeted agents such as epidermal growth factor receptor tyrosine kinase inhibitor and AMG 386. For the development of genomic study in gynecologic cancers, BRCA and DICER1 mutations were covered in epithelial and nonepithelial ovarian cancer, respectively. For endometrial cancer, targeted agents including mammalian target of rapamycin (mTOR) inhibitors and bevacizumab were discussed. Radiation therapy "sandwiched" between combination chemotherapy schedules for the treatment of uterine papillary serous carcinoma was also reviewed. Preoperative prediction of lymph node metastasis, definition of low-risk group, and recurrence and survival outcomes of laparoscopic approaches were addressed. For cervical cancer, we reviewed long-term benefit of human papillomavirus test and efficacy of paclitaxel/carboplatin versus paclitaxel/cisplatin in stage IVB, persistent or recurrent disease. In addition, the effect of three dimensional image-based high-dose rate brachytherapy was also reviewed. For vulvar cancer, the diagnostic value of sentinel lymph node biopsy was discussed. For breast cancer, positive results of three outstanding phase III randomized clinical trials, CLEOPATRA, EMILIA, and BOLERO-2 were introduced. Lastly, updates of major practice guidelines were summarized.
选取了 2012 年妇科肿瘤学的 10 项主要临床研究成果作为主题。在卵巢癌方面,综述了贝伐单抗研究的历史,接着介绍了聚腺苷二磷酸核糖聚合酶(PARP)抑制剂和其他分子靶向药物,如表皮生长因子受体酪氨酸激酶抑制剂和 AMG 386。为了开展妇科癌症的基因组研究,分别介绍了 BRCA 和 DICER1 突变在卵巢上皮性和非上皮性肿瘤中的作用。对于子宫内膜癌,讨论了包括哺乳动物雷帕霉素靶蛋白(mTOR)抑制剂和贝伐单抗在内的靶向药物。还回顾了联合化疗方案中“夹心”放疗治疗子宫乳头状浆液性癌的方法。探讨了经阴道超声术前预测淋巴结转移、定义低危组、腹腔镜治疗的复发和生存结局。在宫颈癌方面,我们综述了人乳头瘤病毒检测的长期获益以及紫杉醇/卡铂与紫杉醇/顺铂在 IVB 期、持续性或复发性疾病中的疗效。此外,还回顾了基于三维图像的高剂量率近距离放疗的效果。外阴癌方面,讨论了前哨淋巴结活检的诊断价值。乳腺癌方面,介绍了三项杰出的 III 期随机临床试验——CLEOPATRA、EMILIA 和 BOLERO-2 的阳性结果。最后,总结了主要实践指南的更新。