宫颈癌根治性放疗前新辅助化疗的意义

Role of Neoadjuvant Chemotherapy Followed by Radical Radiotherapy for Cervical Cancer

宫颈癌是我国发病率第一的妇科恶性肿瘤,严重威胁女性健康。目前宫颈癌的根治性治疗方式包括手术和放疗。新辅助化疗(NACT)在宫颈癌的治疗中应用越来越多,逐渐得到重视,但宫颈癌根治性放疗前的NACT仍有争议。NACT序贯单纯放疗或者同步放化疗,患者基本能够耐受,但总生存期并没有延长。高剂量强度、短周期的NACT可能有助于改善患者预后。对难以耐受同步放化疗的晚期、体弱患者,化疗序贯单纯放疗的疗效与同步放化疗相当,耐受性更好,值得进一步探讨。

Cervical cancer is on the top of gynecologic malignancies in China in terms of incidence,and it is a serious threat to women＇s health. Currently,the radical treatments to cervical cancer include surgery and radiotherapy. Neoadjuvant chemotherapy（ NACT） has been used more and more widely in cervical cancer,and is getting more attention gradually.However,the role of NACT before radical radiotherapy remains controversial. NACT followed by radiotherapy alone or concurrent radiochemotherapy can be well tolerated by the cervical cancer patients in general,but no improvement in overall survival is observed. NACT with high dose intensity and short cycle may conduce to better prognosis. For advanced patients who cannot tolerate concurrent chemoradiotherapy,NACT before radiotherapy alone is as effective as concurrent radiochemotherapy with better tolerance,and it is worthy of further study.