Advances in diagnosis and treatment of metastatic cervical cancer.
Advances in diagnosis and treatment of metastatic cervical cancer.
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DOI：
10.3802/jgo.2016.27.e43
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发表时间：
2016-07
影响因子：
3.9
通讯作者：
Cheng X
中科院分区：
文献类型：
--
作者：
Li H;Wu X;Cheng X
宫颈癌是世界范围内女性最常见的癌症之一。转移性宫颈癌患者的预后较差。我们回顾了有关转移性宫颈癌的治疗和诊断的相关文献。有两种类型的转移与不同的治疗和生存率相关：血行转移和淋巴转移。血行转移的患者比淋巴转移的患者有更高的死亡风险。在诊断方面，氟-2-脱氧-D-葡萄糖正电子发射断层扫描（FDG-PET）和PET-计算机断层扫描是评估远处转移的有效工具。同步放化疗和后续化疗对淋巴结转移有良好的耐受性和效率。对于肺转移，化疗和/或手术是治疗耐药、复发转移性宫颈癌的有效方法，放化疗可能是IVB期宫颈癌的最佳选择。化疗和骨放疗是治疗骨转移癌的有效方法。多模式治疗可获得更好的生存率。开颅手术或立体定向放射外科手术联合放射治疗是治疗单发脑转移瘤的最佳选择。对于多发性脑转移瘤和其他器官转移瘤，可考虑化疗和姑息性脑放疗。
Cervical cancer is one of the most common cancers in women worldwide. The outcome of patients with metastatic cervical cancer is poor. We reviewed the relevant literature concerning the treatment and diagnosis of metastatic cervical cancer. There are two types of metastasis related to different treatments and survival rates: hematogenous metastasis and lymphatic metastasis. Patients with hematogenous metastasis have a higher risk of death than those with lymphatic metastasis. In terms of diagnosis, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and PET-computed tomography are effective tools for the evaluation of distant metastasis. Concurrent chemoradiotherapy and subsequent chemotherapy are well-tolerated and efficient for lymphatic metastasis. As for lung metastasis, chemotherapy and/or surgery are valuable treatments for resistant, recurrent metastatic cervical cancer and chemoradiotherapy may be the optimal choice for stage IVB cervical cancer. Chemotherapy and bone irradiation are promising for bone metastasis. A better survival is achieved with multimodal therapy. Craniotomy or stereotactic radiosurgery is an optimal choice combined with radiotherapy for solitary brain metastases. Chemotherapy and palliative brain radiation may be considered for multiple brain metastases and other organ metastases.