宫颈癌新辅助化疗的疗效评估

Efficacy Evaluation of Neoadjuvant Chemotherapy for Cervical Cancer

宫颈癌是妇科最常见的恶性肿瘤,严重威胁妇女生命健康,是一个亟待解决的全球公共卫生问题。目前,宫颈癌的治疗以手术和放疗为主,化疗为辅。新辅助化疗(neoadjuvant chemotherapy,NACT)是宫颈癌患者临床常用的辅助治疗方案,具有缩小原发肿瘤体积、减少肿瘤转移等优势。然而,由于个体差异性和肿瘤异质性,不是所有患者都对化疗有应答。同时,NACT还有一定的毒性反应,如脱发、中性粒细胞减少和脏器损伤等,甚至可能导致患者死亡。目前临床最常用血清鳞状细胞癌抗原(squamous cell carcinoma antigen,SCC-Ag)和影像学检查来评估NACT的疗效,但具有一定的局限性。从影像学、病理学、分子标志物、毒性反应和生存情况5个方面综述宫颈癌NACT疗效的评估方法,为NACT的临床评估提供依据,并有助于个体化治疗方案的选择和应用。

Cervical cancer is the most common malignant tumor in gynecology,which seriously threatens women′s life and health.It is a global public health problem that needs to be solved urgently.At present,the treatment of cervical cancer is mainly surgery and radiotherapy,supplemented by chemotherapy.Neoadjuvant chemotherapy(NACT)is a commonly used adjuvant therapy for patients with cervical cancer,which has the advantages of reducing the size of the primary tumor and tumor metastasis.However,due to individual variability and tumor heterogeneity,not all patients respond to chemotherapy.At the same time,NACT also has certain toxic reactions,such as hair loss,neutropenia and organ damage,and even lead to the death of patients.At present,serum squamous cell carcinoma antigen(SCC-Ag)and imaging examination are most commonly used to evaluate the efficacy of NACT,but they have some limitations.The evaluation methods of NACT for cervical cancer are reviewed from the aspects of imaging,pathology,molecular markers,toxicity and survival,to provide a basis for the clinical evaluation of NACT,and to help the selection and application of individualized treatment plans.