臨床婦人科産科67巻11号

2013年11月発行

今月の臨床 進行婦人科がんの集学的治療 子宮頸がん

4．子宮頸部腺癌の治療戦略―術前・術後化学療法の意義

著者： 島田宗昭¹ 紀川純三²

所属機関： ¹鳥取大学医学部生殖機能医学 ²鳥取大学医学部附属病院がんセンター

ページ範囲：P.1111 - P.1115

●扁平上皮癌とは異なる治療戦略構築の必要性が指摘されているものの，子宮頸部腺癌に関するエビデンスはきわめて少ない．

●子宮頸部腺癌は放射線療法低感受性であることから，IB～IIB期に対しては，化学療法と手術療法との集学的治療が期待される．

●子宮頸がんに関するエビデンスを本邦から発信する試みが進んでいる．

参考文献

1） 日本婦人科腫瘍学会（編） : 子宮頸癌治療ガイドライン2011年版，2011

2） Cervical Cancer Guideline（version 1.2013）. NCCN Clinical Practice Guidelines in Oncology http://www.nccn.org/professionals/physician_gls/PDF/cervical.pdf

3） Niibe Y, Kenjo M, Onishi H, et al : High-dose-rate intracavitary brachytherapy combined with external beam radiotherapy for stage IIIb adenocarcinoma of the uterine cervix in Japan : a multi-institutional study of Japanese Society of Therapeutic Radiology and Oncology 2006─2007（study by JASTRO 2006─2007）. Jpn J Clin Oncol 40 : 795─799, 2010

4） Baalbergen A, Veenstra Y, Stalpers L : Primary surgery versus primary radiotherapy with or without chemotherapy for early adenocarcinoma of the uterine cervix. Cochrane Database Syst Rev 31 : CD006248, 2013

5） Eddy GL, Bundy BN, Creasman WT, et al : Treatment of（“bulky”）stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy : A phase III trial of the gynecologic oncology group. Gynecol Oncol 106 : 362─369, 2007

6） Katsumata N, Yoshikawa H, Kobayashi H, et al : Phase III randomised controlled trial of neoadjuvant chemotherapy plus radical surgery vs radical surgery alone for stages IB2, IIA2, and IIB cervical cancer : a Japan Clinical Oncology Group trial（JCOG 0102）. Br J Cancer 108 : 1957─1963, 2013

7） Rydzewska L, Tierney J, Vale CL, et al : Neoadjuvant chemotherapy plus surgery versus surgery for cervical cancer. Cochrane Database Syst Rev 20 : CD007406, 2010

8） Shoji T, Kumagai S, Yoshizaki Y, et al : Efficacy of neoadjuvant chemotherapy followed by radical hysterectomy in locally advanced non-squamous cell carcinoma of the uterine cervix : a retrospective multicenter study of Tohoku Gynecologic Cancer Unit. Eur J Gynaecol Oncol 33 : 353─357, 2012

9） Kigawa J, Minagawa Y, Ishihara H, et al : The role of neoadjuvant intraarterial infusion chemotherapy with cisplatin and bleomycin for locally advanced cervical cancer. Am J Clin Oncol 19 : 255─259, 1996

10） Sugiyama T, Nishida T, Kumagai S, et al : Combination therapy with irinotecan and cisplatin as neoadjuvant chemotherapy in locally advanced cervical cancer. Br J Cancer 8 : 95─98, 1999

11） Chen H, Liang C, Zhang L, et al : Clinical efficacy of modified preoperative neoadjuvant chemotherapy in the treatment of locally advanced（stage IB2 to IIB）cervical cancer : A randomized study. Gynecol Oncol 110 : 308─315, 2008

12） Cai HB, Chen HZ, Yin HH, et al : Randomized study of preoperative chemotherapy versus primary surgery for stage IB cervical cancer. J Obstet Gynaecol Res 32 : 315─323, 2006

13） Yamaguchi S, Nishimura R, Yaegashi N, et al : Phase II study of neoadjuvant chemotherapy with irinotecan hydrochloride and nedaplatin followed by radical hysterectomy for bulky stage Ib2 to IIb, cervical squamous cell carcinoma : Japanese Gynecologic Oncology Group study（JGOG 1065）. Oncol Rep 28 : 487─493, 2012

14） Zanetta G, Lissoni A, Gabriele A, et al : Intense neoadjuvant chemotherapy with cisplatin and epirubicin for advanced or bulky cervical and vaginal adenocarcinoma. Gynecol Oncol 64 : 431─435, 1997

15） Takekida S, Fujiwara K, Nagao S, et al : Phase II study of combination chemotherapy with docetaxel and carboplatin for locally advanced or recurrent cervical cancer. Int J Gynecol Cancer 20 : 1563─1568, 2010

16） Iwasaka T, Fukuda K, Hara K, et al : Neoadjuvant chemotherapy with mitomycin, etoposide, and cisplatin for adenocarcinoma of the cervix. Gynecol Oncol 70 : 236─240, 1998

17） Aoki Y, Sato T, Watanabe M, et al : Neoadjuvant chemotherapy using low-dose consecutive intraarterial infusions of cisplatin combined with 5-fluorouracil for locally advanced cervical adenocarcinoma. Gynecol Oncol 81 : 496─499, 2001

18） Saito T, Takehara M, Lee R, et al : Neoadjuvant chemotherapy with cisplatin, aclacinomycin A, and mitomycin C for cervical adenocarcinoma-a preliminary study. Int J Gynecol Cancer 14 : 483─490, 2004

19） Nagao S, Shimada M, Fujiwara K, et al : Neoadjuvant chemotherapy of docetaxel and carboplatin in patients with stage Ib2 to IIb nonsquamous cervix cancer of the uterus. Proc Am Soc Clin Oncol 30 :（Abstr＃5103）, 2012

20） Hosaka M, Watari H, Kato T, et al : Clinical efficacy of paclitaxel/cisplatin as an adjuvant chemotherapy for patients with cervical cancer who underwent radical hysterectomy and systematic lymphadenectomy. J Sur Oncol 105 : 612─616, 2012

21） Angioli R, Plotti F, Montera R, et al : Neoadjuvant chemotherapy plus radical surgery followed by chemotherapy in locally advanced cervical cancer. Gynecol Oncol 127 : 290─296, 2012

22） Shimada M, Nishimura R, Hiura M, et al : Comparison of adjuvant chemotherapy and radiotherapy in patients with cervical adenocarcinoma of the uterus after radical hysterectomy : SGSG/TGCU Intergroup surveillance. Eur J Gynaecol Oncol, 2013（in press）

23） Shimada M, Nishimura R, Nogawa T, et al : Comparison of the outcome between cervical adenocarcinoma and squamous cell carcinoma patients with adjuvant radiotherapy following radical surgery : SGSG/TGCU Intergroup surveillance. Mol Clin Oncol 1 : 780─784, 2013