子宫颈癌术前辅助治疗的规范化

Standardization of preoperative adjuvant therapy for cervical cancer

新辅助化疗(neoadjuvant chemotherapy,NACT)是子宫颈癌术前或放疗前辅助治疗的主要方式,原则上适用于局部晚期(ⅠB3~ⅣA期)和部分特殊类型的子宫颈癌患者。顺铂为首选药物,推荐化疗2~3个疗程。肿瘤直径大于4 cm的ⅠB3~ⅡA2期的子宫颈鳞癌和腺癌的部分患者可以采用新辅助化疗+根治性手术+盆腔淋巴结切除术的治疗模式。子宫颈小细胞神经内分泌肿瘤采用新辅助化疗后行全子宫切除术,术后辅助性放疗或同期放化疗,后续再联合其他全身治疗。规范应用NACT术前辅助治疗子宫颈癌,严格把握适应证,充分发挥其疗效优势至关重要。

Neoadjuvant chemotherapy(NACT)is the primary preoperative adjuvant therapy for cervical cancer.In principle,it is suitable for patients with locally advanced cervical cancer(ⅠB3-ⅣA)and some special types of cervical cancer.Cisplatin is the preferred drug,and chemotherapy for 2-3 courses is recommended.Some patients with stageⅠB3-ⅡA2 cervical squamous cell carcinoma and adenocarcinoma with tumor diameter larger than 4 cm can be treated with radical surgery and pelvic lymphadenectomy after neoadjuvant chemotherapy.For small cell neuroendocrine tumors of the cervix,hysterectomy is performed after neoadjuvant chemotherapy,and then postoperative adjuvant radiotherapy or concurrent chemoradiotherapy is performed,followed by other systemic treatments.It is very important to standardize the application of NACT in preoperative adjuvant treatment of cervical cancer,strictly grasp the indications and contraindications,and give full play to its therapeutic advantages.