Iwata Takashi, Miyauchi Azumi, Suga Yukako, Nishio Hiroshi, Nakamura Masaru, Ohno Akiko, Hirao Nobumaru, Morisada Tohru, Tanaka Kyoko, Ueyama Hiroki, Watari Hidemichi, Aoki Daisuke
1Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan;
2Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
Chin J Cancer Res. 2016 Apr;28(2):235-40. doi: 10.21147/j.issn.1000-9604.2016.02.13.
Neoadjuvant chemotherapy followed by surgery (NCS) has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy (NAC) used in NCS includes cisplatin. The antitumor effects of NAC reduce lymph node metastasis and the tumor diameter in patients prior to surgery, and this can reduce the number of high risk patients who require postoperative radiation therapy. Many randomized controlled trials (RCTs) have examined the long-term prognosis of NCS compared to primary surgery, but the utility of NCS remains uncertain. The advent of concurrent chemoradiotherapy (CCRT) has markedly improved the outcome of radiotherapy (RT), and CCRT is now used as a standard method in many cases of advanced bulky cervical cancer. NCS gives a better treatment outcome than radiation therapy alone, but it is important to verify that NCS gives a similar or better outcome compared to CCRT.
新辅助化疗后手术(NCS)尚未在临床上得到充分评估。目前,NCS中使用的新辅助化疗(NAC)的主要方案包括顺铂。NAC的抗肿瘤作用可减少患者术前的淋巴结转移和肿瘤直径,这可以减少需要术后放疗的高危患者数量。许多随机对照试验(RCT)已经研究了NCS与初次手术相比的长期预后,但NCS的效用仍不确定。同步放化疗(CCRT)的出现显著改善了放疗(RT)的效果,CCRT现在在许多晚期巨大宫颈癌病例中被用作标准方法。NCS比单纯放疗有更好的治疗效果,但重要的是要验证NCS与CCRT相比是否有相似或更好的效果。