Management of Stage IIB Cervical Cancer: an Overview of the Current Evidence

被引:15
作者
Matsuzaki, Shinya [1 ]
Klar, Maximilian [2 ]
Mikami, Mikio [3 ]
Shimada, Muneaki [4 ]
Grubbs, Brendan H. [5 ]
Fujiwara, Keiichi [6 ]
Roman, Lynda D. [1 ,7 ]
Matsuo, Koji [1 ,7 ]
机构
[1] Univ Southern Calif, Div Gynecol Oncol, Dept Obstet & Gynecol, 2020 Zonal Ave IRD520, Los Angeles, CA 90033 USA
[2] Univ Freiburg, Dept Obstet & Gynecol, Freiburg, Germany
[3] Tokai Univ, Sch Med, Dept Obstet & Gynecol, Isehara, Kanagawa, Japan
[4] Tohoku Univ, Dept Obstet & Gynecol, Sch Med, Sendai, Miyagi, Japan
[5] Univ Southern Calif, Div Maternal Fetal Med, Dept Obstet & Gynecol, Los Angeles, CA 90007 USA
[6] Saitama Med Univ, Int Med Ctr, Dept Gynecol Oncol, Saitama, Japan
[7] Univ Southern Calif, Norris Comprehens Canc Ctr, Los Angeles, CA 90007 USA
关键词
Cervical cancer; Stage II; Concurrent chemoradiotherapy; Neoadjuvant chemotherapy; Radical hysterectomy; Survival; SQUAMOUS-CELL-CARCINOMA; FLUOROURACIL PLUS CISPLATIN; RANDOMIZED CONTROLLED-TRIAL; GYNECOLOGIC-ONCOLOGY-GROUP; NEOADJUVANT CHEMOTHERAPY; RADICAL HYSTERECTOMY; PHASE-III; CONCURRENT CHEMORADIATION; CONCOMITANT CHEMOTHERAPY; ADJUVANT RADIOTHERAPY;
D O I
10.1007/s11912-020-0888-x
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose of Review To review and discuss the present evidence of surgery- and radiation-based treatment strategies for stage IIB cervical cancer. Recent Findings Recently, two randomized controlled trials compared the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy (NACT + RH) with that of concurrent chemoradiotherapy (CCRT) for stage IB3-IIB cervical cancer. When these studies were combined (N = 1259), NACT + RH was associated with a shorter disease-free survival [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.13-1.64], but with a similar overall survival (HR 1.11, 95% CI 0.90-1.36) when compared with the findings for CCRT. Stage-specific analysis for stage IIB cervical cancer demonstrated that disease-free survival was significantly worse with NACT + RH than with CCRT (HR 1.90, 95% CI 1.25-2.89); however, no significant difference was observed for stage IB3-IIA cervical cancer. Based on the results of recent level I evidence, the standard treatment for stage IIB cervical cancer remains CCRT.
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页数:15
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