LaVigne Anna W, Triedman Scott A, Randall Thomas C, Trimble Edward L, Viswanathan Akila N
Johns Hopkins University School of Medicine, 733 North Broadway, Suite G49, Baltimore, MD 21205, United States.
The Warren Alpert Medical School of Brown University, United States.
Gynecol Oncol Rep. 2017 Sep 1;22:16-20. doi: 10.1016/j.gore.2017.08.004. eCollection 2017 Nov.
The global cervical cancer burden falls disproportionately upon women in low and middle-income countries. Insufficient infrastructure, lack of access to preventive HPV vaccines, screening, and treatment, as well as limited trained personnel and training opportunities, continue to impede efforts to reduce incidence and mortality in these nations. These hurdles have been substantial challenges to radiation delivery in particular, preventing treatment for a disease in which radiation is a cornerstone of curative therapy. In this review, we discuss the breadth of these barriers, while illustrating the need for adaptive approaches by proposing the use of brachytherapy alone in the absence of available external beam radiotherapy. Such modifications to current guidelines are essential to maximize radiation treatment for cervical cancer in limited resource settings.
全球宫颈癌负担在低收入和中等收入国家的女性中分布不均。基础设施不足、无法获得预防性人乳头瘤病毒（HPV）疫苗、筛查和治疗，以及训练有素的人员和培训机会有限，继续阻碍着这些国家降低发病率和死亡率的努力。这些障碍尤其给放射治疗带来了巨大挑战，使得一种以放射治疗为治愈性疗法基石的疾病无法得到治疗。在本综述中，我们讨论了这些障碍的广度，同时通过提议在没有可用外照射放疗的情况下单独使用近距离放疗来说明采用适应性方法的必要性。对现行指南进行此类修改对于在资源有限的环境中最大限度地进行宫颈癌放射治疗至关重要。
