摘要
宫颈癌是女性常见的恶性肿瘤,其主要的治疗方式是手术和放疗。宫颈癌治疗后复发率高,复发后预后较差。复发宫颈癌可分为盆腔中央型、盆腔外周型和盆腔外复发,其治疗方案取决于患者初始治疗方式和复发位置。无放疗史的患者如有手术指征,可首选手术,也可联合放化疗±近距离治疗。放疗后盆腔中央复发的患者可选择盆腔廓清术±术中放疗,但其适应证具有高选择性,术后并发症发生率高,患者生存质量低。放疗后盆腔外周复发的患者可行再程外放疗和/或化疗。然而再程放疗的严重不良反应发生率高于初次放疗,立体定向体部放疗适应证较严格,对治疗者技术水平的要求也较高。近年来放疗技术更加精准,影像引导的近距离治疗如高剂量率组织间近距离治疗和放射性粒子植入获得了较好的疗效和安全性,为复发宫颈癌提供了新的治疗选择。本文就近年近距离治疗复发性宫颈癌的研究进展进行了梳理和总结。
Cervical cancer is a common malignancy in women.Surgery and radiotherapy are the main therapeutic approaches.The recurrence rate of cervical cancer is high and the prognosis is relatively poor.Recurrent cervical cancer can be classified into the central pelvic,lateral pelvic and extra-pelvic recurrence.The management of recurrent cervical cancer mainly depends on previous therapeutic approaches and the recurrence site.Surgical resection is the optimal option for patients who have no history of radiotherapy,if feasible,chemoradiotherapy±brachytherapy can be considered.Patients with central pelvic recurrence after radiotherapy are suitable candidates for pelvic exenteration±intraoperative radiotherapy.However,the indications are highly selective,the incidence of postoperative complications is high and the quality of life is poor.Patients with lateral pelvic recurrence after radiotherapy could be treated by re-radiotherapy or chemotherapy.However,the incidence of serious side effects of re-radiotherapy is higher than that of the initial radiotherapy.The indications for stereotactic body radiotherapy are limited and the surgical skill of the surgeons is demanding.In recent years,radiotherapy technology has become more precise.Image-guided brachytherapy,such as high-dose-rate interstitial brachytherapy and radioactive 125I seed implantation,has achieved high efficacy and safety,which may provide new treatment options for recurrent cervical cancer.In this article,research progress on brachytherapy for recurrent cervical cancer was summarized and reviewed.
作者
刘龑昊
王俊杰
Liu Yanhao;Wang Junjie(Department of Radiation Oncology,Peking University Third Hospital,Beijing 100191,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2021年第3期297-300,共4页
Chinese Journal of Radiation Oncology
关键词
宫颈肿瘤
复发/近距离放射疗法
宫颈肿瘤
复发/放射性粒子植入疗法
进展
Uterine cervical neoplasm,recurrence/brachytherapy
Uterine cervical neoplasm,recurrence/radioactive seed implantation
Progress
