Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan.
Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Anticancer Res. 2023 Apr;43(4):1397-1405. doi: 10.21873/anticanres.16288.
BACKGROUND/AIM: Small cell neuroendocrine carcinoma of the cervix (SCNEC) is a rare disease characterized by a higher incidence of lymphatic invasion, metastasis, and recurrence compared to the squamous cell carcinoma and adenocarcinoma subtypes. Furthermore, it is prone to early distant metastasis and has a poor prognosis. Chemotherapy has an important role in the management of cervical SCNEC. The effective treatment schemes for early-stage SCNEC are local treatment with radical surgery and systemic chemotherapy. However no standard treatment regimen exists because of a rare disease. We reviewed previous reports to determine whether etoposide/platinum, which is used for histopathologically similar small cell carcinoma of the lung, is an appropriate initial chemotherapy regimen for SCNEC of the cervix.
In this review the Cochrane library sources, ClinicalTrials.gov, Web of Silence, PubMed and search engine of Google scholar were searched for all interventional studies, reviews, case reports and meta-analyses published in 1997-2021.
Etoposide/platinum (EP) is the most commonly used regimen and paclitaxel/carboplatin is the second most common, used as a part of multimodality therapy for SCNEC of the cervix in most studies. Cisplatin/vincristine/bleomycin, cisplatin/irinotecan, cisplatin/ifosfamide/etoposide were also reported in concurrence with EP; however no clinical trials are dedicated to SCNEC.
Etoposide and platinum tend to have a better prognosis compared to other regimens used for other subtypes of cervical cancer. For recurrent cervical SCNEC, treatment options for patients are very limited. The application of molecular testing for targeted mutations may suggest potential future therapies that may be useful in this disease.
背景/目的：宫颈小细胞神经内分泌癌（SCNEC）是一种罕见疾病，与鳞状细胞癌和腺癌亚型相比，其具有更高的淋巴侵袭、转移和复发率。此外，它易发生早期远处转移，预后较差。化疗在宫颈 SCNEC 的治疗中具有重要作用。早期 SCNEC 的有效治疗方案是根治性手术和全身化疗的局部治疗。但是，由于疾病罕见，因此不存在标准的治疗方案。我们回顾了以往的报告，以确定对于宫颈 SCNEC，是否使用与组织病理学相似的小细胞肺癌的依托泊苷/铂类药物作为初始化疗方案是合适的。
在本次综述中，我们在 Cochrane 图书馆资源、ClinicalTrials.gov、Web of Silence、PubMed 和 Google Scholar 搜索引擎中检索了 1997 年至 2021 年期间发表的所有干预性研究、综述、病例报告和荟萃分析。
依托泊苷/铂类（EP）是最常用的方案，紫杉醇/卡铂是第二常用的方案，在大多数研究中，作为宫颈 SCNEC 多模态治疗的一部分。顺铂/长春新碱/博来霉素、顺铂/伊立替康、顺铂/异环磷酰胺/依托泊苷也与 EP 同时报告；然而，没有专门针对 SCNEC 的临床试验。
与用于其他宫颈癌亚型的其他方案相比，依托泊苷和铂类药物往往具有更好的预后。对于复发性宫颈 SCNEC，患者的治疗选择非常有限。分子检测靶向突变的应用可能提示未来可能对该疾病有用的潜在治疗方法。
