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KMID : 0377619970620050464
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Korean Jungang Medical Journal
1997 Volume.62 No. 5 p.464 ~ p.464
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A Review of Strategies in the Treatment of Cervical Cancer
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Wharton, J. Taylor
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Abstract
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Three treatment areas are important in patients with invasive carcinoma of the cervix. Successful treatment requires different strategies for each of the following situations.
(T) Carcinoma confined to the cervix
(N) Spread beyond the cervix to lymph nodes
(M) Spread to distant sites (systemic spread)
Numerous successful strategies have evolved to treat the cervix cancer. Radical hysterectomy or radiotherapy for cancers confined to the cervix
Radiotherapy alone, or combined radiotherapy and surgery for large lesions confined to the cervix
? Concomitant chemotherapy and radiotherapy for carcinoma with extension to adjacent structures
? Concomitant use of radiotherapy and radiation sensitizers
Carcinomas that have spread to lymph nodes present a difficult problem. Different strategies are used. Extended-field radiotherapy Retroperitoneal staging laparotomy followed by extended-field radiotherapy or chemotherapy. The most complex patient to treat is the patient with extensive carcinoma in the cervix and lymph nodes and with distant metastases very likely or documented. In these situations it is desirable to attain local control. The followings are therapy considerations.
? Extended-field radiotherapy with or without radio sensitizers followed by adjuvant chemotherapy Neoadjuvant chemotherapy followed by surgery or radiotherapy. Radiation therapy or surgery or both followed by new systemic therapy. Cervix cancer remains a lethal cancer. The rapid advances in understanding cell growth from the basic molecular biology viewpoint will hopefully provide molecular targets will enhance therapies used to treat this cancer.
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