Durch konsequentes Screening hat sich in den letzten Jahren in den Ländern der westlichen Welt sowohl die Inzidenz als auch die Mortalitätsrate für das invasive Zervixkarzinom verringert. Therapie der Wahl bei Zervixkarzinomen ist in den Stadien I B und II A die radikale Operation, in den höheren Stadien die primäre Strahlentherapie. Es bleibt aber die Feststellung, daß sich in den letzten Jahren die Behandlungsergebnisse nicht verbessert haben. Aus kleinen Studien ist bekannt, daß auch Zervixkarzinome auf eine Chemotherapie ansprechen. Die Resultate von fünf großen randomisierten Studien haben gezeigt, daß eine cisplatinhaltige Chemotherapie dann einen Überlebensvorteil für die Patientinnen mit invasivem Zervixkarzinom hatte, wenn diese simultan zur Strahlentherapie gegeben wurde. Die Nebenwirkungen waren moderat und vorübergehend. Die Ergebnisse lassen die Schlußfolgerung zu, daß eine simultane Radiochemotherapie mit Cisplatin sowohl in der primären als auch in high-risk-Fällen in der adjuvanten Therapie eingesetzt werden sollte.
Adjuvant pelvic radiation and chemotherapy for cervical cancer
Summary
The screening for cervical cancer has been reduced both the incidence of and mortality from invasive cervical cancer in the western world. Radical pelvic surgery is an effective treatment for early invasive cervical cancer (FIGO-stage I B and II A), but for woman with more advanced disease radiotherapy is the standard treatment. However, the survival of the cervical cancer patients has not been inproved over the last decade. Previous studies have suggested that chemotherapy and radiotherapy are synergistic. The results of five large studies have shown that cisplatin-based chemotherapy when given at the same time a radiation therapy, prolongs survival in woman with cervical cancer. This was also observed in primary treatment schedule as in adjuvant situation. The side effects were temporary and manageable. The results suggest that chemoradiation is the favorable therapy for cervical cancer in advanced stage and in high-risk-situation.
Schlüsselwörter
Zervixkarzinom - Strahlentherapie - Chemotherapie
Key words
Cervix cancer - radiotherapy - chemotherapy
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