Medical Oncology Department, H. Universitario Marqués de Valdecilla, Santander, Spain.
Medical Oncology Department, H. Universitario La Paz, Madrid, Spain.
Clin Transl Oncol. 2020 Feb;22(2):270-278. doi: 10.1007/s12094-019-02271-z. Epub 2020 Jan 24.
Cervical cancer (CC) is the fourth most common cancer in women worldwide, strongly linked to high-risk human papilloma virus infection. In high-income countries, the screening programs have dramatically decreased the incidence of CC; however, the lack of accessibility to them in developing countries makes CC an important cause of mortality. Clinical stage is the most relevant prognostic factor in CC. The new FIGO staging system published in 2018 is more accurate than the previous one since it takes into account the lymph node status. In early stages, the primary treatment is surgery-with some concerns recently raised regarding minimally invasive surgery because it might decrease survival-or radiotherapy, whereas concomitant chemo-radiotherapy is the conventional approach in locally advanced stages. For recurrent or metastatic CC, the combination of chemotherapy plus bevacizumab is the preferred therapy. Immunotherapy approach based on checkpoint inhibitors is evolving as the election therapy following failure to platinum therapy.
宫颈癌(CC)是全球女性中第四常见的癌症,与高危型人乳头瘤病毒感染密切相关。在高收入国家,筛查计划显著降低了 CC 的发病率;然而,发展中国家缺乏对这些计划的可及性,使得 CC 成为一个重要的死亡原因。临床分期是 CC 最重要的预后因素。2018 年发布的新 FIGO 分期系统比以前的系统更准确,因为它考虑了淋巴结状态。在早期阶段,主要的治疗方法是手术——最近有人对微创手术提出了一些担忧,因为它可能会降低生存率——或者放疗,而同期放化疗是局部晚期的常规治疗方法。对于复发性或转移性 CC,化疗加贝伐珠单抗的联合治疗是首选。基于检查点抑制剂的免疫治疗方法正在发展,作为铂类治疗失败后的首选治疗方法。