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局部晚期宫颈癌的管理。

The management of locally advanced cervical cancer.

机构信息

Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India.

出版信息

Curr Opin Oncol. 2018 Sep;30(5):323-329. doi: 10.1097/CCO.0000000000000471.

Abstract

PURPOSE OF REVIEW

Cervical cancer is still a major cause of morbidity and mortality among women worldwide. Surgery and chemoradiation are widely utilized treatments for cervical cancer. Despite the available standard treatment of choice, outcome is suboptimal among patients with LACC. It is vital to integrate the evidence generated from high-quality research work for effective management of these cases. This review intends to critically evaluate the latest evidence supporting the available treatment modalities and to provide a comprehensive overview of recent advances and ongoing research in the management of LACC.

RECENT FINDINGS

Research advances in imaging and radiotherapy technologies, incorporating imaging into brachytherapy planning, use of newer targeted agents, chemotherapy intensification and immunotherapy are some of the new therapeutic options that have been in the forefront of research to improve the outcome of patients with LACC.

SUMMARY

Advanced imaging modalities are increasingly being utilized to tailor treatments. Neoadjuvant chemotherapy followed by surgery does not improve outcomes in FIGO Stage IB2-IIB. Although cisplatin-based concurrent chemoradiation is the standard of care, more aggressive systemic therapies (neoadjuvant or adjuvant chemotherapy and chemoradiation) and use of newer agents, still remains investigational.

摘要

目的综述

宫颈癌仍然是全世界女性发病率和死亡率的主要原因。手术和放化疗广泛用于宫颈癌的治疗。尽管有标准的治疗方法,但 LACC 患者的治疗效果仍不理想。将高质量研究工作产生的证据整合起来,对于这些病例的有效管理至关重要。这篇综述旨在批判性地评估支持现有治疗方法的最新证据,并对 LACC 治疗的最新进展和正在进行的研究进行全面概述。

最新发现

影像学和放疗技术的研究进展,将影像学纳入近距离放疗计划,使用新型靶向药物,化疗强化和免疫治疗是一些新的治疗选择,这些选择一直处于研究的前沿,以改善 LACC 患者的治疗效果。

总结

先进的影像学方法越来越多地被用于治疗。新辅助化疗后手术并不能提高 FIGO 分期 IB2-IIB 的疗效。虽然顺铂为基础的同期放化疗是标准治疗,但更积极的全身治疗(新辅助或辅助化疗和放化疗)和新型药物的使用仍处于研究阶段。

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