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Abstract：
BACKGROUND: Concurrent chemoradiation is the standard treatment for advanced cervical cancer. However some patients still have a poor prognosis, and currently, there is no effective treatment for recurrence. In recent years, 125I seed implantation therapy has emerged as a treatment for advanced malignant tumors including surgically unresectable tumors, residual tumors after surgical resection, and metastatic tumors. However, the use of 125I seeds implantation in primary advanced cervical cancer has not been reported. In this study, we present a case of stage IIIB cervical cancer in a patient who had poor response to radiotherapy and chemotherapy. Subsequently, a radical hysterectomy was performed, and 125I radioactive seeds were successfully implanted during the surgery. This effectively controlled the lesions that were resistant to radiotherapy and had the potential to improve the prognosis.
METHODS: A 56-year-old woman was diagnosed with stage IIIB (FIGO 2009) IIIC1r (FIGO 2018) squamous carcinoma of the cervix. After receiving 4 cycles of platinum-based chemotherapy and 30 rounds of radiotherapy, she underwent a radical hysterectomy. The localized cervical lesions were reduced, but there was no reduction in the size of the enlarged pelvic lymph nodes. Therefore, 125I seed implantation was performed under direct surgical vision for the right paracervical lesion and the enlarged pelvic lymph nodes on the right side. During the 18-month follow-up period, the enlarged lymph nodes subsided without any signs of recurrence or metastasis.
CONCLUSIONS: Intraoperative implantation of 125I seeds in lesions that are difficult to control with radiotherapy or in sites at high risk of recurrence is a feasible and effective treatment option for patients with advanced squamous cervical cancer, and it may contribute to improved survival.
METHODS: A 56-year-old woman was diagnosed with stage IIIB (FIGO 2009) IIIC1r (FIGO 2018) squamous carcinoma of the cervix. After receiving 4 cycles of platinum-based chemotherapy and 30 rounds of radiotherapy, she underwent a radical hysterectomy. The localized cervical lesions were reduced, but there was no reduction in the size of the enlarged pelvic lymph nodes. Therefore, 125I seed implantation was performed under direct surgical vision for the right paracervical lesion and the enlarged pelvic lymph nodes on the right side. During the 18-month follow-up period, the enlarged lymph nodes subsided without any signs of recurrence or metastasis.
CONCLUSIONS: Intraoperative implantation of 125I seeds in lesions that are difficult to control with radiotherapy or in sites at high risk of recurrence is a feasible and effective treatment option for patients with advanced squamous cervical cancer, and it may contribute to improved survival.
摘要：
背景：同步放化疗是晚期宫颈癌的标准治疗方法。然而，一些患者的预后仍然较差，目前,目前尚无有效的复发治疗方法。近年来,125I粒子植入疗法已成为晚期恶性肿瘤的治疗方法，包括手术不可切除的肿瘤，手术切除后残留肿瘤，和转移性肿瘤。然而,125I粒子植入在原发性晚期宫颈癌中的应用尚未见报道.在这项研究中,我们介绍了一例对放疗和化疗反应不佳的IIIB期宫颈癌患者。随后，进行了根治性子宫切除术,手术中成功植入了125I放射性粒子。这有效地控制了对放疗有抵抗力的病变，并有可能改善预后。
方法：一名56岁女性被诊断患有IIIB期（FIGO2009）IIIC1r（FIGO2018）宫颈鳞癌。在接受4周期铂类化疗和30轮放疗后，她接受了根治性子宫切除术。局部宫颈病变减少，但盆腔淋巴结肿大没有缩小。因此,在直视手术下对右侧宫颈旁病变和右侧盆腔淋巴结肿大进行125I粒子植入。在18个月的随访期间，肿大的淋巴结消退，没有任何复发或转移的迹象。
结论：对放疗难以控制的病灶或复发风险高的部位，术中植入125I粒子是晚期宫颈鳞癌患者可行且有效的治疗选择。它可能有助于提高生存率。
方法：一名56岁女性被诊断患有IIIB期（FIGO2009）IIIC1r（FIGO2018）宫颈鳞癌。在接受4周期铂类化疗和30轮放疗后，她接受了根治性子宫切除术。局部宫颈病变减少，但盆腔淋巴结肿大没有缩小。因此,在直视手术下对右侧宫颈旁病变和右侧盆腔淋巴结肿大进行125I粒子植入。在18个月的随访期间，肿大的淋巴结消退，没有任何复发或转移的迹象。
结论：对放疗难以控制的病灶或复发风险高的部位，术中植入125I粒子是晚期宫颈鳞癌患者可行且有效的治疗选择。它可能有助于提高生存率。
