早期高危宫颈癌术后同期放化疗研究进展

摘要

宫颈癌是常见妇科恶性肿瘤之一,位居全球2012年新发病例和死亡病例第四位.早期高危宫颈癌术后需要辅助治疗.术后同期放化疗较术后单纯放疗降低盆腔外复发率并提高生存率,较术后序贯放化疗延长中位生存时间和生存率.术后同期放化疗后巩固性化疗较术后单纯同期放化疗提高生存率.回顾性研究表明术后同期放化疗与术后单纯化疗疗效相当,但仍需进一步研究.影响术后同期放化疗疗效的因素主要包括化疗方案、放疗技术、手术与同期放化疗的时间间隔、多发盆腔淋巴结转移和盆腔淋巴结清扫个数等.术后同期放化疗不良反应主要包括血液学不良反应和胃肠道不良反应,其中血液学不良反应最常见.放疗技术的进步可改善不良反应发生率.%Cervical cancer is one of the most common gynecologic malignancy,ranking fourth in new cases and deaths in 2012.High-risk early stage cervical cancer after operative need adjuvant treatment.Compared with postoperative radiotherapy alone,CCRT can reduce the pelvic recurrence rates and improve survival rates. And CCRT can extend median survival time and survival rates than sequential CRT after operative. CCRT plus consolidation chemotherapy may play a potential role in further improving survival outcomes for high-risk early stage cervical cancer patients compared with CCRT alone. Retrospective studies show that CCRT had equivalent effects with postoperative chemotherapy alone,but further research is needed. Factors influencing the efficacy of postoperative CCRT include chemotherapy regimens,radiotherapy technology,the interval time between surgery and CCRT,multiple pelvic lymph node metastasis and number of pelvic lymph node dissection. Toxicities mainly include hematologic and gastrointestinal toxicity. Hematologic toxicity is the most common. The incidence of toxicity can be reduced by improving radiotherapy techniques.