Bizzarri Nicolò, Kyrgiou Maria, De Vincenzo Rosa, Zapardiel Ignacio, Razumova Zoia, Taumberger Nadja, Toth Ico, Theofanakis Charalampos, Gultekin Murat, Joura Elmar A
UOC Ginecologia Oncologica, Dipartimento di Scienze Della Salute Della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
Int J Gynaecol Obstet. 2025 May;169(2):597-604. doi: 10.1002/ijgo.16120. Epub 2024 Dec 30.
Many clinicians recommend that patients diagnosed with HPV-related gynecologic cancers receive prophylactic HPV vaccination at the time of cancer diagnosis or after cancer treatment. In view of the large use of such practice, we aimed to assess the literature evidence supporting the use of prophylactic HPV vaccines after diagnosis or treatment of HPV-related gynecologic cancers. Women who develop HPV-related cervical, vaginal, and vulvar cancers represent a subgroup of patients who may be particularly sensitive to HPV infection and re-acquire infections. The rationale that the use of prophylactic HPV vaccination at the time or after treatment for cervical, vaginal, and vulvar cancers might reduce the risk of future HPV-related diseases might be explained by the data coming from the use of HPV vaccination after treatment of pre-invasive disease; however, the evidence on the use of HPV vaccination in the setting of HPV-related gynecologic cancers is currently absent. In this context, observational and experimental studies document an important drop in effectiveness of HPV vaccination by age. Physicians should be aware of catch-up programs in their countries and should be ready to counsel patients about prophylactic HPV vaccine efficacy according to their age. In general, no evidence exists supporting the use of prophylactic HPV vaccine in patients diagnosed with HPV-related gynecologic cancers; therefore, the European Society of Gynecological Oncology (ESGO) prevention committee opinion is to counsel these patients as any HPV-related non-gynecologic cancer (such as anal or oropharyngeal cancer) and non-cancer patient, suggesting vaccination according to patient's age and prognosis, knowing there is a decrease of efficacy with increasing age. Studies on the use of prophylactic HPV vaccine in patients diagnosed with HPV-related gynecologic cancers are strongly needed.
许多临床医生建议，被诊断患有HPV相关妇科癌症的患者在癌症诊断时或癌症治疗后接受预防性HPV疫苗接种。鉴于这种做法的广泛应用，我们旨在评估支持在HPV相关妇科癌症诊断或治疗后使用预防性HPV疫苗的文献证据。罹患HPV相关宫颈癌、阴道癌和外阴癌的女性是可能对HPV感染特别敏感并再次感染的患者亚组。在宫颈癌、阴道癌和外阴癌治疗时或治疗后使用预防性HPV疫苗可能会降低未来HPV相关疾病风险的基本原理，或许可以用来自于对癌前病变治疗后使用HPV疫苗的数据来解释；然而，目前尚缺乏关于在HPV相关妇科癌症情况下使用HPV疫苗的证据。在这种背景下，观察性和实验性研究记录了HPV疫苗效力随年龄的显著下降。医生应该了解本国的补种计划，并应随时根据患者年龄为其提供关于预防性HPV疫苗效力的咨询。一般而言，没有证据支持在被诊断患有HPV相关妇科癌症的患者中使用预防性HPV疫苗；因此，欧洲妇科肿瘤学会（ESGO）预防委员会的意见是，像对待任何HPV相关非妇科癌症（如肛门癌或口咽癌）患者和非癌症患者一样为这些患者提供咨询，建议根据患者年龄和预后进行疫苗接种，要知道随着年龄增长效力会降低。非常需要对被诊断患有HPV相关妇科癌症的患者使用预防性HPV疫苗的研究。
