Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China.
Curr Oncol. 2022 Jul 25;29(8):5262-5277. doi: 10.3390/curroncol29080418.
The recurrence rate of cervical cancer after primary treatment can reach 60%, and a poor prognosis is reported in most cases. Treatment options for the recurrence of cervical cancer mainly depend on the prior treatment regimen and the location of recurrent lesions. Re-irradiation is still considered as a clinical challenge, owing to a high incidence of toxicity, especially in in-field recurrence within a short period of time. Recent advances in radiotherapy have preliminarily revealed encouraging outcomes of re-irradiation. Several centers have concentrasted on stereotactic body radiation therapy (SBRT) for the treatment of well-selected cases. Meanwhile, as the image-guiding techniques become more precise, a better dose profile can also be achieved in brachytherapy, including high-dose-rate interstitial brachytherapy (HDR-ISBT) and permanent radioactive seed implantation (PRSI). These treatment modalities have shown promising efficacy with a tolerable toxicity, providing further treatment options for recurrent cervical cancer. However, it is highly unlikely to draw a definite conclusion from all of those studies due to the large heterogeneity among them and the lack of large-scale prospective studies. This study mainly reviews and summarizes the progress of re-irradiation for recurrent cervical cancer in recent years, in order to provide potential treatment regimens for the management of re-irradiation.
宫颈癌患者经初次治疗后复发率可达 60%，且多数患者预后不良。宫颈癌复发的治疗选择主要取决于先前的治疗方案和复发病灶的位置。由于毒性发生率高，尤其是在短期内发生的靶区内复发，再次放疗仍然是一个临床挑战。放射治疗的最新进展初步显示了再次放疗的令人鼓舞的结果。一些中心专注于立体定向体部放疗（SBRT）治疗精选病例。同时，随着影像引导技术越来越精确，近距离放疗也可以实现更好的剂量分布，包括高剂量率间质近距离放疗（HDR-ISBT）和永久性放射性粒子植入（PRSI）。这些治疗方法具有良好的疗效和可耐受的毒性，为复发性宫颈癌提供了进一步的治疗选择。然而，由于这些研究之间存在很大的异质性，且缺乏大规模前瞻性研究，因此不太可能从所有这些研究中得出明确的结论。本研究主要综述和总结了近年来复发性宫颈癌再次放疗的进展，以期为复发性宫颈癌的再放疗管理提供潜在的治疗方案。
