Qin Yi, Guan Ping, Li Dan, He Huailin, He Wenfeng, Tan Longjing, Deng Xiangyu, Liao Bizhen, Wen Qinglian, Zhang Zhenhua
Department of Oncology, The Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, Sichuan, China.
Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Oncol. 2024 Jan 15;13:1330681. doi: 10.3389/fonc.2023.1330681. eCollection 2023.
Treatment of metastatic cervical cancer is a tricky issue. Currently, the National Comprehensive Cancer Network (NCCN) guideline recommends chemotherapy combined with bevacizumab for recurrent or metastatic cervical cancer. Still, the recurrence rate is high and the survival rate is low after standard treatment. We urgently need to achieve a multimodal therapy approach for recurrent or metastatic cervical cancer.
We report the case of a patient with stage IB2 cervical squamous carcinoma who developed multiple metastases within a short term after receiving first-line standard treatment, and she underwent interstitial brachytherapy after systemic therapy with an encouraging outcome. The patient developed suspected inguinal lymph node metastases after 9 months at the end of first-line therapy and multiple metastases in the inguinal lymph nodes, anterior abdominal wall, and right lung after 17 months. As the patient had residual inguinal lymph nodes after systemic therapy, she received 3D-printed template-guided interstitial brachytherapy to the inguinal lymph nodes and maintenance therapy. By Sep 2023, she had achieved a good treatment outcome with a progression-free survival (PFS) of 36 months.
Based on our patient response, when multiple metastases develop in the short term in early-stage cervical squamous carcinoma after first-line therapy, we may consider implementing local therapy combined with systemic therapy.
转移性宫颈癌的治疗是一个棘手的问题。目前,美国国立综合癌症网络(NCCN)指南推荐化疗联合贝伐单抗用于复发或转移性宫颈癌。然而,标准治疗后的复发率高且生存率低。我们迫切需要实现针对复发或转移性宫颈癌的多模式治疗方法。
我们报告了一例IB2期宫颈鳞状癌患者,该患者在接受一线标准治疗后短期内出现多处转移,在全身治疗后接受了组织间近距离放疗,结果令人鼓舞。该患者在一线治疗结束9个月后出现可疑腹股沟淋巴结转移,17个月后腹股沟淋巴结、前腹壁和右肺出现多处转移。由于患者在全身治疗后腹股沟淋巴结有残留,她接受了3D打印模板引导的腹股沟淋巴结组织间近距离放疗及维持治疗。截至2023年9月,她取得了良好的治疗效果,无进展生存期(PFS)为36个月。
基于我们患者的反应,当早期宫颈鳞状癌在一线治疗后短期内出现多处转移时,我们可考虑实施局部治疗联合全身治疗。