Dueñas-González Alfonso, Campbell Sergio
aInstituto de Investigaciones Biomédicas UNAM/Instituto Nacional de Cancerología, Mexico City bUnidad de Medicina Familiar IMSS 53 Zapopan Jalisco, Zapopan, Mexico.
Curr Opin Obstet Gynecol. 2016 Feb;28(1):11-7. doi: 10.1097/GCO.0000000000000234.
Recent peer-reviewed publications on the treatment of early, locally advanced and advanced cervical cancer patients are reviewed to gain insight into the main research done in the field.
In early-stage patients where cure is offered to most patients, research focuses on more conservative or less morbid approaches to increase quality of life and reduce the treatment-related sexual dysfunction. No major advances have occurred for treating locally advanced disease since the introduction of concurrent chemoradiation, but efforts are directed to increase efficacy while reducing toxicity with the use of combination chemoradiation and modern radiation technologies. Molecular-targeted therapy and identification of targetable gene alterations as well as immunotherapy are actively pursued in patients with advanced disease.
Although global statistics indicate a trend for decreased age-standardized incidence rates, social and economical factors impede the uptake of therapeutic advances achieved as many patients have no access even to basic resources for treating cancer. The adherence to quality indicators in delivery of optimized standard concurrent chemoradiation and adherence to guidelines in cervical cancer surgery must not be underestimated. Major efforts are needed in both the scientific and social aspects of cervical cancer treatment to reduce mortality.
回顾近期关于早期、局部晚期和晚期宫颈癌患者治疗的同行评审出版物,以深入了解该领域的主要研究情况。
在大多数患者有望治愈的早期患者中,研究重点在于采用更保守或创伤更小的方法,以提高生活质量并减少治疗相关的性功能障碍。自同步放化疗引入以来,局部晚期疾病的治疗没有取得重大进展,但目前正致力于通过联合放化疗和现代放疗技术提高疗效并降低毒性。晚期疾病患者积极采用分子靶向治疗、可靶向基因改变的鉴定以及免疫治疗。
尽管全球统计数据显示年龄标准化发病率有下降趋势,但社会和经济因素阻碍了治疗进展的应用,因为许多患者甚至无法获得治疗癌症的基本资源。在提供优化的标准同步放化疗时遵守质量指标以及在宫颈癌手术中遵守指南,这一点绝不能被低估。在宫颈癌治疗的科学和社会层面都需要做出重大努力以降低死亡率。