臨床婦人科産科69巻1号

2015年01月発行

今月の臨床 ゲノム時代の婦人科がん診療を展望する─がんの個性に応じたpersonalizationへの道

【各論1】子宮頸がん

4．再発子宮頸がんに対する個別的アプローチ

著者： 河野光一郎¹ 牛嶋公生¹

所属機関： ¹久留米大学医学部産婦人科学講座

ページ範囲：P.63 - P.69

文献概要

●照射野内再発は難治性で化学療法の奏効率は照射野外と比べて低い．手術は侵襲が大きく合併症の問題もあるが，長期生存報告例がある．

●照射野外再発は場所と個数により，手術もしくは放射線療法が可能かの検討が必要である．不可の場合は化学療法を選択する．

●化学療法はタキサン＋プラチナ製剤が標準治療であるが，ベバシズマブを含めた分子標的療法の併用に期待がもてる．

参考文献

1） Jover R, et al : Role of PET/CT in the evaluation of cervical cancer. Gynecol Oncol 110（suppl 2）: 55─59, 2008

2） Plante M, et al : Operative laparoscopy prior to a pelvic exenteration in patients with recurrent cervical cancer. Gynecol Oncol 69 : 94─99, 1998

3） Kohler C, et al : Explorative laparoscopy prior to exenterative surgery. Gynecol Oncol 86 : 311─315, 2002

4） Coleman RL, et al : Radical hysterectomy for recurrent carcinoma of the uterine cervix after radiotherapy. Gynecol Oncol 55 : 29─35, 1994

5） Maneo A, et al : Radical hysterectomy for recurrent or persistnet cervical cancer following radiation therapy. Int J Gynecol Cancer 9 : 295─301, 1999

6） Brunschwig A : The surgical treatment of cancer of the cervix uteri. Bull NY Acad Med 24 : 672─683, 1948

7） Peiretti M, et al : Management of recurrent cervical cancer : A review of the literature. Surg Oncol 21 : e59─e66, 2012

8） Hockel M : Laterally extended endopelvic resection. Novel surgical treatment of locally recurrent of loacally recurrent cervical carcinoma involving the pelvic side wall. Gynecol Oncol 91 : 369─377, 2003

9） Jobsen JJ, et al : Treatment of locoregional recurrence of carcinoma of the cervix by radiotherapy after primary surgery. Gynecol Oncol 33 : 368─371, 1989

10） Grigsby PW : Radiotherapy for pelvic recurrence after radical hysterectomy for cervical cancer. Radiat Med 23 : 327─330, 2005

11） Wang CJ, et al : Recurrent cervical carcinoma after primary radical surgery. Am J Obstet Gynecol 181 : 518─524, 1999

12） Grigsby PW : Prospective phase I/II study of irradiation and concurrent chemotherapy for recurrent cervical cancer after radical hysterectomy. Int J Gynecol Cancer 14 : 860─864, 2004

13） Mabuchi S, et al : Reirradiation using high-dose-rate interstitial brachytherapy for locally recurrent cervical cancer : a single institutional experience. Int J Gynecol Cancer 24 : 141─148, 2014

14） Zoliack-Siwinska A, et al : HDR brachytherapy for the reirradiation of cervical and vaginal cancer : analysis of efficacy and dosage delivered to organs at risk. Gyncol Oncol 132 : 93─97, 2014

15） Badakh DK, et al : Reirradiation with high-dose-rate remote afterloading brachytherapy implant in patients with locally recurrent or residual cervical carcinoma. J Cancer Res Ther 5 : 24─30, 2009

16） Pectasides D, et al : Carboplatin and paclitaxel in metastatic or recurrent cervical cancer. Int J Gynecol Cancer 19 : 777─781, 2009

17） Scatchard K, et al : Chemotherapy for metastatic and recurrent cervical cancer. Cochrane Database Syst Rev 10 : CD006469, 2012

18） Perez CA, et al : Irradiation alone or combined with surgery in stage IB, IIA, and IIB carcinoma of the uterine cervix : update of a nonrandomized comparison. Int J Radiat Oncol Biol Phys 31 : 703─716, 1995

19） Niibe Y, et al : Multiinstitutional study of radiation therapy for isolated para-aortic lymph node recurrence in uterine cervical carcinoma : 84 subjects of a population of more than 5,000. Int J Radiat Oncol Biol Phys 66 : 1366─1369, 2006

20） Chou HH, et al : Isolated paraaortic lymph node recurrence after definitive irradiation for cervical carcinoma. Int J Radiat Oncol Biol Phys 51 : 442─448, 2001

21） Singh AK, et al : Cervix carcinoma, concurrent chemoradiotherapy, and salvage of isolated paraaortic lymph node recurrence. Int J Radiat Oncol Biol Phys 61 : 450─455, 2005

22） Yamamoto K, et al : Pulmonary metastasectomy for uterine cervical cancer : a multivariate analysis. Ann Thorac Surg 77 : 1179─1182, 2004

23） Okunieff P, et al : Stereotactic body radiation therapy（SBRT）for lung metastases. Acta Oncol 45 : 808─817, 2006

24） Sze WM, et al : Palliation of metastatic bone pain : single fraction versus multifraction radiotherapy -a systematic review of the randomized trials. Cochrane Database Syst Rev 2 : CD004721, 2004

25） Wong R, et al : Bisphosphonates for the relief of pain secondary to bone metastases. Cochrane Database Syst Rev 2 : CD002068, 2002

26） Roquei Figuls M, et al : Radioisotopes for metastatic bone pain（Review）. Cochrane Database Syst Rev 7 : CD003347, 2011

27） Loblaw DA, et al : Emergency treatment of malignant extradural spinal cord compression : an evidence-based guideline. J Clin Oncol 16 : 1613─1624, 1998

28） 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，pp148，金原出版，2011

29） Moore DH, et al : Phase III study of cisplatin with or without paclitaxel in stage IVB, recurrent, or persistent squamous cell carcinoma of the cervix : a Gynecologic Oncology Group study. J Clin Oncol 22 : 3113─3119, 2004

30） Long III HJ, et al : Randomized phase III trial of cisplatin with or without topotecan in carcinoma of the uterine cervix : a Gynecologic Oncology Group study. J Clin Oncol 23 : 4626─4633, 2005

31） Monk BJ, et al : Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma : a Gynecologic Oncology Group study. J Clin Oncol 27 : 4649─4655, 2005

32） Tewari KS, et al : Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med 370 : 734─743, 2014

33） Kitagawa R, et al : A randomized phase III trial of paclitaxel plus carboplatin（TC） versus paclitaxel plus cisplatin（TP） in stage IVb, persistent or recurrent cervical cancer : Japan Clinical Oncology Group study（JCOG0505）. J Clin Oncol 30（Abstr 5006）. 2012