- 期刊
Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer: An 2002 Update
先期輔助性化學治療局部性晚期子宮頸癌：2002年回顧
摘要
目的：對於婦癌科與放射腫瘤科醫師而言，治療局部性晚期子宮頸癌（尤其有巨大病灶者）是一項桃戰。目前的標準治療為協同化學治療加放射治療。然而，療效仍有持改進。 病案範例：一位40歲婦女因罹患第三B期巨大子宮頸癌併有大量陰道出血，於1992年2月被轉送到本院。經過三天300 Rads/day的緊急放射治療止血後，患者接受了三次的先期輔助性化學治療(cisplatin, vincristine, bleomycin)。在局部腫瘤大幅消退之後，患者接受了根除性子宮切除與主動脈旁暨骨盆腔淋巴結摘除手術。儘管手術標本裡僅有1.5×1.5×0.5公分的殘餘子宮頸癌而並無其他病理學危險因子，患者仍接受了手術後之輔助性放射治療。迄今十年，患者無復發跡象，且無重大合併症。 結論：先期輔助性化學治療之後加上根除性子宮摘除手術與輔助性放射治療，可以讓局部性晚期子宮頸癌患者長期存活，並且無重大合併症。為了改善局部性晚期子宮頸癌息者的存活率，此多方複合治療值得進一步研究。
並列摘要
Locally advanced cervical cancer, especially those with bulky primary lesion, is a challenge to both gynecologic oncologists and radiologic oncologists. The current standard treatment is concurrent chemoradiation. However, treatment results remain to be improved. A 40-year-old women was referred to Mackay Memorial Hospital for a bulky stage IIIB cervical carcinoma with massive vaginal bleeding on February 17, 1992. After emergent radiotherapy with 300cGy/day for 3 consecutive days for controlling tumor bleeding, the patient received 3 cycles of neoadjuvant chemotherapy with cisplatin, oncovin and bleomycin. After achieving optimal clinical response, the patient underwent radical hysterectomy with bilateral pelvic lymphadenectomy. Postoperative adjuvant radiotherapy was arranged despite pathology examination revealed only a 1.5×1.5×0.5cm residual cervical carcinoma without any pathologic risk factors. The patient has been doing well without major complication for 10 years. Neoadjuvant chemotherapy followed by radical hysterectomy and adjuvant radiotherapy may achieve long-term survival without major complication in locally advanced cervical cancer. To improve the survival of locally advanced cervical cancer, multi-modality managements warrant further investigation.
延伸閱讀
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- 龔晏萱、王鵬惠、陳怡仁（2021）。晚期子宮頸腺癌復發的治療：病例討論及文獻回顧。婦癌醫學期刊，(54)，23-27。https://www.airitilibrary.com/Article/Detail?DocID=P20150521002-202110-202201280017-202201280017-23-27
- Wang, L., Ho, S. C., Jan, J. S., & Lin, J. C. (2010). 子宮頸癌接受合併化學放射治療後發生單獨主動脈淋巴腺轉移之拯救性治療：病例報告. 放射治療與腫瘤學, 17(1), 39-45. https://doi.org/10.6316/TRO/201017(1)39