Todo Yukiharu, Watari Hidemichi
Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo 003-0804, Japan;
Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo 060-8648, Japan.
Chin J Cancer Res. 2016 Apr;28(2):221-7. doi: 10.21147/j.issn.1000-9604.2016.02.10.
Concurrent chemoradiotherapy (CCRT) is regarded as the standard treatment for locally advanced uterine cervical cancer (LACC), including stage Ib2-IVa disease [International Federation of Gynecology and Obstetrics (FIGO) staging]. However, approximately a third of eligible patients in previous studies died of LACC despite receiving CCRT. The therapeutic significance of CCRT alone in stage III-IVa disease has not yet been confirmed. Effective treatment of some LACC is beyond the scope of CCRT. The objective of the present review is to highlight some challenging work aimed at overcoming this seemingly intractable disease. CCRT with increased peak concentrations of cisplatin (CDDP), surgery following CCRT, adjuvant chemotherapy (CT) following CCRT, and neoadjuvant CT followed by CCRT are strategies expected to enhance the therapeutic efficacy of CCRT. If patients with LACC were divided into those with low-risk or high-risk systemic disease or prognoses, novel strategies should be assessed in the group with high-risk disease.
同步放化疗（CCRT）被视为局部晚期子宫颈癌（LACC，包括国际妇产科联盟（FIGO）分期中的Ib2-IVa期疾病）的标准治疗方法。然而，在先前的研究中，约有三分之一符合条件的患者尽管接受了CCRT，但仍死于LACC。CCRT单独用于III-IVa期疾病的治疗意义尚未得到证实。某些LACC的有效治疗超出了CCRT的范围。本综述的目的是强调一些旨在攻克这种看似棘手疾病的具有挑战性的工作。增加顺铂（CDDP）峰值浓度的CCRT、CCRT后手术、CCRT后辅助化疗（CT）以及新辅助CT后进行CCRT等策略有望提高CCRT的治疗效果。如果将LACC患者分为具有低风险或高风险全身疾病或预后的患者，应在高风险疾病组中评估新策略。
