- 期刊
Induction Chemotherapy Followed by Radiotherapy in Locally Advanced Cervical Cancer: A Review
廣泛侵犯性子宮頸癌的前導性化學治療合併放射治療
摘要
近30年來，廣泛侵犯性子宮頸癌的預後並未明顯改善，然而放射治療仍為治療的主力。目前仍待突破的治療重點不外乎改善局部控制率及有效治療隱匿性轉移病灶“過去曾有加入手術、缺氧細胞致敏劑、高壓氧，或中子治療等方式，然大都因療效有限或因明顯副作用而致成效不彰。目前則以合併化學藥物的方式被研究最多，其中「前導性化學治療」的作法是一項較新的嚐試，其化學藥物的組成大都是以含有cisplatin的多種藥物組合“回顧文獻鬢現部份研究者提出肯定的報告，但亦有些學者指出這種治療方式與單獨使用放射治療作比較，並無法有效提高局部控制或存活率。因此，前導性化學治療合併放射治療的實際價值如何，則有賴更進一步的研究。
並列摘要
The prognosis for locally advanced cervical cancer has not improved in the past 3 decades. The strategies for improving the outcome include better local control as well as effective management of occult metastases already present at diagnosis. Radiotherapy has always been the standard treatment for these stages. The addition of other modalities including surgery, hypoxic cell sensitizer, hyperbaric oxygen, or neutron therapy has met with limited or no success, or has been associated with an increased morbidity. The role of chemotherapy, either as single agent or in combination, has been extensively evaluated in advanced or recurrent disease. Induction or neoadjuvant chemotherapy is one of the novel therapeutic approaches. Various regimens have been used, mostly cisplatin-based combinations. Several investigators conducted phase II trials of neoadjuvant chemotherapy. Some of these trials showed positive result. Nevertheless, some failed to demonstrate any benefit in terms of locoregional relapse and/or survival At present, the optimum regimen that lends to a maximum efficacy and a minimum toxicity remains to be determined. We have to learn whether the induction chemotherapy eventually improves survivals or is yet another approach that just demonstrates good responses without impact on survival.
延伸閱讀
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- 賴耿光、馬玉麟、許瑞昌、葉坤土、賴義雄、林隆堯、周明智（2002）。子宮頸癌術後放射線治療病人組織病理學預後因子之多變數分析。放射治療與腫瘤學，9(1)，53-63。https://doi.org/10.6316/TRO/200209(1)53
- 李耀泰、趙呈祥、許國邦、徐文成、林顯明（1996）。子宮頸癌之新輔助化學治療和肋膜內cisplatin治療：一病例報告。Journal of Medical Sciences，17(1)，42-47。https://www.airitilibrary.com/Article/Detail?DocID=10114564-199608-201306130015-201306130015-42-47
- 顏明賢（2004）。子宮頸癌治療系列報導－參、化學治療。中華民國婦癌醫學雜誌，(2004年1)，1-18。https://doi.org/10.7010/JGO.200404.0001
- Leung, C. M., Hu, Y. C., Chen, C. H., Liu, W. S., Kan, Y. Y., & Chang, C. H. (2004). 初期子宮頸癌之手術後放射線治療. 放射治療與腫瘤學, 11(2), 71-79. https://doi.org/10.6316/TRO/200411(2)71