子宮頸癌經化學放射線治療後，以刮除術來評估持續病灶

Using Curettage to Evaluate Persistent Tumor after Chemoradiation of Cervical Cancer

局部晚期子宮頸癌會以化學放射線治療，然治療後如何追蹤尚不清楚。目前常見的方法有子宮頸抹片、電腦斷層、磁振造影、腫瘤指數及臨床檢查，然上述檢查的靈敏率和特異率差異頗大。子宮刮除術乃一簡單和併發症較少的手術，子宮頸癌患者經化學放射線治療後，可施以子宮刮除術來判斷是否有子宮頸殘留病灶，如發現有，則考慮手術切除子宮，以增加治癒率，並避免治療不足或過度治療。

Chemoradiation remains the recommended primary treatment for locally advancedcervical cancer. However, the best follow-up remains unclear. The mostfrequently used methods of surveillance are clinical examination, Papanicolaousmear, ultrasound, computed tomography (CT), magnetic resonance tomography(MRI), and tumor markers. Sensitivity and specificity of these examinationsvary greatly. Dilatation and curettage (D&C) is a relatively simple procedurewith minimal morbidity. Routine curettage seems to be used as a guide decisionfor secondary hysterectomy after chemotherapy for cervical cancer. The patientswould probably benefit from salvage hysterectomy after positive curettage. Bycontrast, hysterectomy can be avoided if curettage is negative. Therefore, underorover-treatment could be avoided.