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首页> 外文期刊>Vaccine >Treatment of cervical cancer in Italy: strategies and their impact on the women.
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Treatment of cervical cancer in Italy: strategies and their impact on the women.

机译：意大利子宫颈癌的治疗：策略及其对妇女的影响。

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Treatment of cervical cancer greatly varies according to the stage of the disease. Laparoscopic surgical staging is emerging as a valid approach, compared to clinical and imaging staging, to better identify the treatment plan. Minimally invasive surgery plays the greatest role in the treatment of early cervical carcinoma (ECC). Laparoscopically assisted radical vaginal hysterectomy (LARVH) is an alternative surgical strategy in this subset of patients. Interest has been increasing in using conservative fertility-sparing surgery such as laparoscopic vaginal radical trachelectomy (LVRT) or chemo-conization, options to be preferred in selected patients, with early-stage disease and asking for future fertility. Chemoradiotherapy currently represents the gold standard in the treatment of patient with locally advanced cervical cancer (LACC). In Italy, neoadjuvant chemotherapy (NACT) followed by radical surgery is today emerging as a valid alternative to the standard chemoradiation and the paclitaxel, ifosfamide and cisplatin (TIP) regimen is one of the most active neoadjuvant chemotherapeutic treatments. Moreover, the combination of different strategies to maximize local control should be considered. Among different approaches to this issue the use of a three-modality treatment, including radiotherapy, chemotherapy and surgery has been investigated. Our data on a large single-institutional series of LACC patients treated with chemoradiation followed by radical surgery confirm that this three-modality treatment can achieve overall survival (OS) and Disease Free Survival (DFS) rates at least comparable to chemoradiation alone, with an acceptable rate of complications. Tailoring of radical surgery, on the basis of intraoperative findings, such as lympho-nodes status, might play an important role in diminishing the overall rate of complications and eventually improve quality of life (QoL) of these patients. Cervical cancer generally has an aggressive impact on relatively young women and, as we experienced, the relevance of psychosocial aspects in gynaecologic oncology has become a main issue.
机译：子宫颈癌的治疗因疾病的阶段而异。与临床和影像学分期相比，腹腔镜手术分期正在成为一种有效的方法，以更好地确定治疗计划。微创手术在早期宫颈癌（ECC）的治疗中起着最大的作用。腹腔镜辅助的根治性子宫全子宫切除术（LARVH）是这部分患者的另一种手术策略。使用保守的保留生育能力的手术如腹腔镜阴道根治性气管切开术（LVRT）或化学造影术的兴趣不断增加，在某些患有早期疾病并要求将来生育的患者中，首选这些选择。放化疗目前是治疗局部晚期宫颈癌（LACC）患者的金标准。在意大利，新辅助化疗（NACT）继而进行根治性手术正在成为标准化学放疗的有效替代方法，紫杉醇，异环磷酰胺和顺铂（TIP）方案是最活跃的新辅助化学疗法之一。此外，应考虑不同策略的组合以最大化本地控制。在解决该问题的不同方法中，已经研究了使用三种方式的治疗方法，包括放射疗法，化学疗法和外科手术。我们对接受化学放疗并接受根治性手术的大型单机构LACC患者的数据证实，这种三联疗法可以达到总体生存率（OS）和无病生存率（DFS），至少与单独进行化学放疗可比。可接受的并发症发生率。根据术中发现的结果（例如淋巴结状况）来定制根治性手术，可能在降低并发症的总体发生率并最终改善这些患者的生活质量（QoL）中起重要作用。宫颈癌通常会对相对年轻的女性产生侵略性影响，正如我们所经历的，妇科肿瘤学中社会心理方面的相关性已成为一个主要问题。

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