晚期子宮頸腺癌復發的治療：病例討論及文獻回顧

Treatment for recurrent advance cervical adenocarcinoma a case report and literature review

子宮頸腺癌復發、轉移、持續且不可手術的患者，全身性治療可以比照子宮頸鱗狀上皮癌。在上述患者中，第一線的藥物為標靶治療合併鉑金類化學治療，如Bevacizumab＋Cisplatin＋Paclitaxel。若是因過敏或無效等原因而無法使用鉑金類的患者，可以選用Bevacizumab＋Paclitaxel＋Topotecan取代。標靶藥物的副作用已證實包括頭痛、高血壓及腸胃道瘻管，但是對於該病人餘生的生活品質並無統計上的影響，在經濟許可的狀況下應當成第一線合併使用。若遇無法使用標靶藥物情況，單用複合性的化學治療藥物療效最佳者為Carboplatin＋Paclitaxel，其次為Cisplatin＋Paclitaxel，若又遇到鉑金類無法耐受的患者，可以選用Paclitaxel＋Topotecan作為全身性治療。

The treatment for persistent, recurrent, or advanced cervical adenocarcinoma could follow squamous cervical carcinoma treatment. First line chemotherapy include platium-based chemotherapy plus target therapy, for example, cisplatin and paclitaxel plus bevacizumab. If regimen not usable due to allergic reason, it could substitute above regimen with paclitaxel and topotecan plus bevacizumab. Side effect of bevacimzab include headache, hypertension and gastrointestinal fistula, which has no statistically effect for quality of life. Hence, under affordable circumstances, target therapy should be considered as first line therapy for advanced cervical adenocarcinoma. However, if target therapy is not affordable, the best first line chemotherapy is carboplatin plus paclitaxel, following by cisplatin plus paclitaxel. In platium-based intolerable patients, paclitaxel plus topotecan should be used in platium-based instead as systemic treatment.