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Cervical cancer is the second most common female cancer worldwide. In Thailand, it also ranks the second most common cancer in female while the most common cancer is breast cancer. This is the national statistic reported in 2010 with the age-standardized incident rate 18.1 per 100,000 women year). There are approximate 500,000 new cases from all over the world each year. Around twenty-seven thousand cases died from the disease, Seventy percent of cervical cancer cases occur in developing countries. Although cervical cancer is a preventable disease, investigators still work hard to find the solution to eliminate it. Cervical cancer treatment has been studied; there are still many aspects of treatment modalities that are on developmental process. This article will focus in the changing views about cervical cancer and some of the update issues during past 10 years.
In summary, surgery is ideal for young healthy women with small lesions. Occasionally, radiation, usually with chemotherapy, is recommended if high risk factors are discovered intra-operatively. Larger tumors are treated without surgery using a combination of radiation (external and internal therapy) and weekly cisplatin chemotherapy. Finally, for those with recurrent, metastatic or widespread lesions (stage IVB) participation in the four arm GOG protocol 204 is recommended.
Attasara P. Srivatanakul P, Sriplung H. Cancer Incidence in Thailand. In: Khuhaprema T, Srivatanakul P. Attasara P, Sriplung H, Wiangnon S, Sumitsawan Y, eds. Cancer in Thailand Volume. V, 2001-2003. Bangkok; 2010:52. http://www.nci.go.th/th/File_download/Nci%20Cancer%20Registry/Book%20Cancer%20In%20Thailand%202010%20for%20Web.pdf.
Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340(15):1144-1153. doi:10.1056/NEJM199904153401502.
Eifel PJ. Concurrent chemotherapy and radiation: a major advance for women with cervical cancer. J Clin Oncol. 1999;17(5):1334-1335. doi:10.1200/JCO.19184.108.40.2064.
Peters WA 3rd, Liu PY, Barrett RJ 2nd, Stock RJ, Monk BJ, Berek JS, et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol. 2000;18(8):1606-1613. doi:10.1200/JCO.2000.18.8.1606.
Rydzewska L, Tierney J, Vale CL, Symonds PR. Neoadjuvant chemotherapy plus surgery versus surgery for cervical cancer. Cochrane Database Syst Rev. 2010;(1):CD007406. doi:10.1002/14651858.CD007406.pub2.
Tierney JF, Vale C, Symonds P. Concomitant and neoadjuvant chemotherapy for cervical cancer. Clin Oncol (R Coll Radiol). 2008;20(6):401-416. doi:10.1016/j.clon.2008.04.003.
Moore DH, Blessing JA, McQuellon RP, Thaler HT, Cella D, Benda J, 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. 2004;22(15):3113-3119. doi:10.1200/JCO.2004.04.170.
Long HJ 3rd, Bundy BN, Grendys EC Jr, Benda JA, McMeekin DS, Sorosky J, 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. 2005;23(21):4626-4633. doi:10.1200/JCO.2005.10.021.
Monk BJ, Huang HQ, Cella D, Long HJ 3rd; Gynecologic Oncology Group Study. Quality of life outcomes from a randomized phase III trial of cisplatin with or without topotecan in advanced carcinoma of the cervix: a Gynecologic Oncology Group Study. J Clin Oncol. 2005;23(21):4617-4625. doi:10.1200/JCO.2005.10.522.
Monk BJ, Sill MW, McMeekin DS, Cohn DE, Ramondetta LM, Boardman CH, 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. 2009;27(28):4649-4655. doi:10.1200/JCO.2009.21.8909.