Current Standards in the Management of Early and Locally Advanced Cervical Cancer: Update on the Benefit of Neoadjuvant/Adjuvant Strategies

Cancers

Patricia Pautier¹  Elie Rassy¹  Catherine Genestie²  Alexandre Coutte³  Yuedan Zhou³  Sophie Espenel⁴  Cyrus Chargari⁴  Samir Achkar⁴  Sébastien Gouy⁵  Philippe Morice⁵ 

[1] Department of Medical Oncology, Gustave Roussy Comprehensive Cancer Centre, 94800 Villejuif, France;Department of Pathology, Gustave Roussy Comprehensive Cancer Center, 94800 Villejuif, France;Department of Radiation Oncology, Centre Hospitalier Universitaire, 80000 Amiens-Picardie, France;Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Centre, 94800 Villejuif, France;Department of Surgery, Gustave Roussy Comprehensive Cancer Center, 94800 Villejuif, France;

关键词: cervical cancer;    radiation oncology;    brachytherapy;    chemotherapy;    immunotherapy;   

DOI  :  10.3390/cancers14102449

来源: DOAJ

【 摘 要 】

Globally, cervical cancers continue to be one of the leading causes of cancer-related deaths. The primary treatment of patients with early-stage disease includes surgery or radiation therapy with or without chemotherapy. The main challenge in treating these patients is to maintain a curative approach and limit treatment-related morbidity. Traditionally, inoperable patients are treated with radiation therapy solely and operable patients undergo upfront surgery followed by adjuvant (chemo) radiotherapy in cases with poor histopathological prognostic features. Patients with locally advanced cervical cancers are treated with concurrent chemoradiotherapy followed by an image-guided brachytherapy boost. In these patients, the main pattern of failure is distant relapse, encouraging intensification of systemic treatments to improve disease control. Ongoing trials are evaluating immunotherapy in locally advanced tumours following its encouraging efficacy reported in the recurrent and metastatic settings. In this article, clinical evidence of neoadjuvant and adjuvant treatments in cervical cancer patients is reviewed, with a focus on potential strategies to improve patients’ outcome and minimize treatment-related morbidity.

【 授权许可】

Unknown