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02 November 2018, Volume 34 Issue 11 Previous Issue    Next Issue

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Preoperative treatments for locally advanced cervical cancer. DI Wen，YU Min-hua 2018, 34(11): 1190-1193.  DOI: 10.19538/j.fk2018110102 Abstract ( )   The morbidity and mortality of cervical cancer in developing countries have been increasing year by year.Gynecologic oncologists face with huge challenges due to difficulty in treatment and poor prognosis of locally advanced cervical cancer.Owing to individual differences and uneven development of regional health services，the choices of treatment options for locally advanced cervical cancer remain controversial.Concurrent chemoradiotherapy is the standard treatment option for locally advanced cervical cancer in developed countries such as the United States and Canada.In Europe and Asia，especially in developing countries and regions，surgical treatment is selected after adjuvant therapy.This article describes the selection of preoperative treatments for locally advanced cervical cancer based on relevant literature and guidelines.

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Radiotherapy for locally advanced cervical cancer. LONG Xing-tao，GUO Ming-fang 2018, 34(11): 1193-1199.  DOI: 10.19538/j.fk2018110103 Abstract ( )   The incidence of cervical cancer is still high in developing countries.Nearly 80% are diagnosed as locally advanced cervical cancer（LACC）.The National Comprehensive Cancer Network（NCCN）recommends that LACC patients be treated with pelvic radiotherapy，intracavitary brachytherapy and cisplatin-based concurrent chemotherapy.At present，the 5-year survival rate of LACC patients is still around 70%.In this paper，the basic methods，principles and therapeutic effects of radiotherapy for LACC patients are briefly reviewed，and the progress of radiotherapy，including precise radiotherapy，concurrent chemotherapy，neoadjuvant chemotherapy，post-radiotherapy consolidated chemotherapy，surgical pathological staging and combined targeted therapy，is reviewed and discussed.

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Benefits of preoperative neoadjuvant chemotherapy for locally advanced cervical carcinoma. ZHANG Shi-qian，WANG Wen 2018, 34(11): 1199-1203.  DOI: 10.19538/j.fk2018110104 Abstract ( )   The standard treatment for locally advanced cervical carcinoma is still controversial，and the application of neoadjuvant chemotherapy has not reached consensus worldwide；moreover，its clinical therapeutic efficacy is also uncertain.A series of clinical trials have shown that preoperative neoadjuvant chemotherapy plays an important role in the treatment of locally advanced cervical carcinoma，but we should make clear the indications and contraindications of the treatment and take full consideration of the advantages and disadvantages before it is implemented.The therapeutic efficacy of preoperative neoadjuvant chemotherapy for locally advanced cervical carcinoma remains to be further verified.

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Choice of chemotherapy regimen and medicine for locally advanced cervical cancer. ZHAO Wei-dong 2018, 34(11): 1203-1207.  DOI: 10.19538/j.fk2018110105 Abstract ( )   The treatment for locally advanced cervical cancer is currently controversial.NCCN recommends direct radiotherapy，but the damage is greater.Neoadjuvant chemotherapy combined with radical surgery is currently used in many countries and regions.However，there is no uniform chemotherapy regimen，dose or strength.In order to screen patients who are not sensitive to neoadjuvant chemotherapy so as to develop a more reasonable treatment regimen and avoid delay in the timing of treatment，large sample，random multicenter results are needed.This article reviews the problems related to neoadjuvant chemotherapy for cervical cancer in order to provide a theoretical basis for clinical treatment.

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Characteristics and significance of arterial vascular network in locally advanced cervical cancer. LIU Ping 2018, 34(11): 1207-1211.  DOI: 10.19538/j.fk2018110106 Abstract ( )   The diagnosis of cervical cancer is based on gynecological examinations.It is difficult to accurately diagnose the degree of invasion into parametrial tissue and the invasion into bladder and rectum，especially in locally advanced cervical cancer（LACC）.LACC also has many high risk factors and poor prognosis.The choice of treatment has always been controversial.By qualitative and quantitative analysis of LACC digital three-dimensional arterial network，the local size and depth of invasion in cervical cancer were judged，and the extent of invasion in vagina，uterine corpus，parametrium and adjacent organs were accurately diagnosed by the source of blood supply artery and characteristics of blood flow.The analysis of LACC digitized three-dimensional arterial network provides the basis for choosing the appropriate operation method and evaluating the difficulty and prognosis of the operation.

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Research progress and future of immunotherapy for advanced and recurrent cervical cancer. ZONG Li-ju，XIANG Yang 2018, 34(11): 1211-1216.  DOI: 10.19538/j.fk2018110107 Abstract ( )   In recent years，immunotherapy，especially immunological checkpoint inhibitor，has made breakthroughs in cancer therapy.This article will summarize the latest progress in immunotherapy for cervical cancer，focusing on the efficacy，safety and predictive markers of immune checkpoint inhibitors in cervical cancer，and review the future research direction of cervical cancer immunotherapy.

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Current status and future of targeted therapy for patients with local advanced cervical cancer. ZHANG Gu-yu，ZHU Yi-min 2018, 34(11): 1216-1220.  DOI: 10.19538/j.fk2018110108 Abstract ( )   In recent years，with the popularization of cervical cancer screening，the global incidence of cervical cancer is declining gradually.However，more than 80% of cervical cancer occurs in developing countries，and the incidence rate of cervical cancer in young women is rising.For patients with advanced cervical cancer，radiotherapy and chemotherapy have a moderate effect，but the median survival time is just one year.Targeted therapy makes great achievement in advanced cancer treatment.Clinical trials suggest that bevacizumab combined with chemotherapy effectively prolongs the overall survival time of patients with cervical cancer.On the other side，more and more targeted drugs are being used in the treatment of advanced cervical cancer.

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Management of urinary injury caused by surgery for local advanced cervical cancer. SONG Lei 2018, 34(11): 1220-1223.  DOI: 10.19538/j.fk2018110109 Abstract ( )   Local advanced cervical cancer is a type of gynecological malignant tumors with poor prognosis and high recurrence rate.As the main treatment method，surgical treatment is likely to cause bladder injury and ureteral injury and other complications.The treatment methods and strategies of urinary system injury including bladder injury and ureteral injury were described in this paper.

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Role of pelvic exenteration in the treatment of recurrent cervical cancer. LIU Ji-hong，HUANG He 2018, 34(11): 1223-1226.  DOI: 10.19538/j.fk2018110110 Abstract ( )   Pelvic exenteration offers another chance of cure for cervical cancer patients with recurrent diseases in central pelvis.For those with recurrence of lateral pelvic wall，palliative pelvic exenteration can also play a role in relieving symptoms and improving the quality of life.Surgical margin is the most important factor for prognosis after this surgery. Therefore，it is critical to have evaluation before surgery，considering the possibility of clear margin according to clinical manifestation，pelvic examination and imaging characteristics，combined with the history of treatment，general physical and psychological status，as well as surgical exploration.Based on the careful selection of cases and operative approaches，the patients could benefit from the exenteration surgery.