宫颈癌标准治疗选择.pptxVIP

宫颈癌标准治疗选择第1页/共35页 6/26/20232Cancers of the Female Reproductive Tract:Worldwide Statistics1 Ferlay et al. GLOBOCAN 2000 IARC, WHO 2001 (www.dep.iarc.fr) CancerNew CasesDeathsCervical470,000230,000Endometrial189,00045,000Ovarian192,000114,000USANorthern EuropeSouthern Europe23,80010,00010,20015,6007,2006,200第2页/共35页 6/26/202331974-2000上海市居民妇科肿瘤发病率上海市肿瘤研究流行病研究室年报告第3页/共35页 6/26/20234第4页/共35页 6/26/20235第5页/共35页 6/26/20236Treatment Option Overview Five randomized phase III trials have shown an overall survival advantage for cisplatin-based therapy given concurrently with radiation therapy,[1-6] while 1 trial examining this regimen demonstrated no benefit.[7]The risk of death from cervical cancer was decreased by 30% to 50% by concurrent chemoradiation. Based on these results, strong consideration should be given to the incorporation of concurrent cisplatin- based chemotherapy with radiation therapy in women who require radiation therapy for treatment of cervical cancer.[1-8]第6页/共35页 6/26/20237Treatment Option OverviewSurgery and radiation therapy are equally effective for early-stage small-volume disease.[9] Younger patients may benefit from surgery in regard to ovarian preservation and avoidance of vaginal atrophy and stenosis. Patterns of care studies clearly demonstrate the negative prognostic effect of increasing tumor volume. Therefore, treatment may vary within each stage as currently defined by FIGO, and will depend on tumor bulk and spread pattern.[10] 第7页/共35页 6/26/20238Treatment Option OverviewTherapy of patients with cancer of the cervical stump is effective, yielding results comparable to those seen in patients with an intact uterus.[11] During pregnancy, no therapy is warranted for preinvasive lesions of the cervix, including carcinoma in situ, although expert colposcopy is recommended to exclude invasive cancer. Treatment of invasive cervical cancer during pregnancy depends on the stage of the cancer and gestational age at diagnosis.第8页/共35页 6/26/20239宫颈癌分