子宮頸癌是全世界女性罹患率第三高的癌症。根據估計在2008年子宮頸癌有530,000個新發生的病例(約佔所有女性診斷癌症的近十分之一(9%))。根據FIGO年度報告，IB1和IB2的五年存活率從90%大幅下降到75%。IB2的治療方式比其他期別更有爭議：包括同步化學及放射治療、直接子宮頸癌根除性手術及後腹腔淋巴腺切除術，以及同步化學及放射治療後再加子宮切除，每種方法都有其優缺點。在IB2子宮頸癌的治療，術前輔助化療後再行根除性子宮切除術較單純手術提高存活率。強度調控放射治療(IMRT)和同期化療，跟傳統同步化療合併放射線治療比較起來有類似的療效，同時於急性和晚期毒性也較低。既然，對於子宮頸癌IB2的患者，這兩種治療策略都有其優點，究竟哪一種方式更好，或直接手術、直接放射線治療，需要以臨床試驗來確定。然而，在已發表之醫學文獻中，這方面之比較較少。因此，我們希望藉由本回溯性的研究，來針對子宮頸癌IB2之治療方式進行探討。 Cervical cancer is the third leading cause of female cancer worldwide. It is estimated to be responsible for 530,000 new cases of cancer in 2008 (nearly one in ten (9%) of all cancers diagnosed in women). From the FIGO annual repot the average 5 year survival rate drop dramatically from 90% to 75% for stage IB1 and IB2, respectively. The treatment policy for stage IB2 is more controversial than other stages and including concomitant chemoradiation, primary radical hysterectomy with retroperitoneal lymph dissection, and concomitant chemoradiation followed by hysterectomy. Each method has their benefits and shortcomings.In treatment stage IB2 cervical cancer, neoadjuvant chemotherapy followed by radical hysterectomy will improve survival compare to operation alone. Intensity modulated radiotherapy (IMRT) and concomitant chemotherapy was found to have good efficacy at the same time favorable acute and late toxicities.Now that these two treatment strategies both offer benefits to stage IB2 cervical cancer patients, which one should be the first choice, including: radical hysterectomy, neoadjuvant chemotherapy followed by radical hysterectomy, radiotherapy, or concomitant chemoradiation therapy should be determined by clinical trials. However, from Pubmed search, there were only few studies involving the comparison of these four methods of treatment. Therefore , we hope that through this retrospective study to explore ways for the treatment of cervical cancer IB2.
