宫颈癌分期治疗研究状态综述

目的探讨基于临床评估的宫颈癌分期对治疗选择的影响。方法复习近年来宫颈癌方面的研究文献,予以综述。结果微侵袭性宫颈癌可通过非根治性手段治愈。Ib~IIa期宫颈癌,根治性手术与根治性放疗效果相当,但存在并发症差异。术式选择需综合考虑分期及个体选择。根治性手术前的新辅助化疗可提高Ib期生存期。联合应用化、放疗为IIb~IVa期的新标准方法。结论针对个体化、宫颈癌分期、年龄、临床状态及肿瘤相关因素等的综合对策在宫颈癌治疗中疗效可靠。

Therapic Progress in Different Stage of Cervical Cancer

Objective Treatment of invasive cervical cancer is affected by the stage of the disease, which is based on clinical evaluation. Method Reviewing later articles related therapic strategy of cervical cancer. Result Microinvasive carcinoma of the cervix has limited metastatic potential and therefore is most likely curable by non-radical treatment. Both radical surgery and radical radiotherapy have been proven to be effective equally, but differ in associated complications. In common, stage Ib1 cervical cancer is treated by radical hysterectomy with pelvic lymphadenectomy. Comparing with the modality, Laparoscopically assisted radical vaginal hysterectomy has shown similar efficacy and recurrence rates. In small cervical cancer where preservation of fertility is desired,radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy may be an option. Neoadjuvant chemotherapy followed by radical surgery may improve a survival in patients with stage Ib cervical carcinoma. Concomitant chemo-radiation is becoming a new standard in treatment of advanced disease, because it has been clearly shown to improve disease-free, progression-free and overall survival. Conclutions Treatment decisions should be individualized and based on multiple factors including the stage of the disease, age, medical condition of the patient, tumor-related factors and treatment preferences, to yield the best cure with minimum complications.