Harvard Radiation Oncology Program, Harvard Medical School, Boston, Massachusetts, USA.
Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Int J Gynecol Cancer. 2022 Mar;32(3):231-238. doi: 10.1136/ijgc-2021-002491.
Worldwide, stage III-IVA carcinomas of the uterine cervix comprise a significant proportion of cases at presentation, and have a higher rate of recurrence and worse overall survival. This review will discuss the epidemiology, prevention strategies, clinical presentation, and treatment recommendations for stage III-IVA cervical cancer. The focus will be on the role of radiation therapy, concurrent chemoradiotherapy, and brachytherapy, including the potential benefits and anticipated toxicities. The unique challenges and considerations of fistula formation and approaches to management will be highlighted, and follow-up care and future directions discussed. As low and middle income countries bear the highest burden of advanced stage carcinoma of the uterine cervix, this review will address the unique needs of global communities.
在全球范围内，III-IVA 期宫颈癌在就诊时占了相当大的比例，其复发率更高，总体生存率更差。本文将讨论 III-IVA 期宫颈癌的流行病学、预防策略、临床表现和治疗建议。重点将放在放疗、同期放化疗和近距离放疗的作用上，包括潜在的益处和预期的毒性。将突出强调瘘管形成的独特挑战和处理方法，并讨论随访护理和未来方向。由于中低收入国家承担着晚期宫颈癌的最大负担，因此本文将针对全球社区的独特需求进行讨论。
