Advances in diagnosis and treatment of metastatic cervical cancer

Abstract

Cervical cancer is one of the most common cancers in women worldwide. The outcome of patients with metastatic cervical cancer is poor. We reviewed the relevant literature concerning the treatment and diagnosis of metastatic cervical cancer. There are two types of metastasis related to different treatments and survival rates: hematogenous metastasis and lymphatic metastasis. Patients with hematogenous metastasis have a higher risk of death than those with lymphatic metastasis. In terms of diagnosis, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and PET-computed tomography are effective tools for the evaluation of distant metastasis. Concurrent chemoradiotherapy and subsequent chemotherapy are well-tolerated and efficient for lymphatic metastasis. As for lung metastasis, chemotherapy and/or surgery are valuable treatments for resistant, recurrent metastatic cervical cancer and chemoradiotherapy may be the optimal choice for stage IVB cervical cancer. Chemotherapy and bone irradiation are promising for bone metastasis. A better survival is achieved with multimodal therapy. Craniotomy or stereotactic radiosurgery is an optimal choice combined with radiotherapy for solitary brain metastases. Chemotherapy and palliative brain radiation may be considered for multiple brain metastases and other organ metastases.

Radiotherapy Improves the Survival of Patients With Metastatic Cervical Cancer: A Propensity-Matched Analysis of SEER Database

“…The most common site of metastasis is lung (21%); bone metastasis occurs in 16% of patients. 2,11 The role of RT to intropelvic and extrapelvic sites is not well-established and thus is an ongoing study topic.…”

Modulation of Tumor Cell Metabolism by Laser Photochemotherapy with Cisplatin or Zoledronic Acid In Vitro

“…There is growing evidence that cisplatin-based chemotherapy has a positive impact on survival (46). As bone metastases are present in up to 22.9% of patients (21), bisphosphonates such as ZA are clinically effective (47), even though no positive effects on survival rates were observed (48). In a clinical setting, laser photochemotherapy comprising cisplatin or ZA together with additional LLLT could help to improve treatment of locally advanced cancer.…”

“…However, the effect of laser-mediated chemotherapy on cellular viability and metabolism of cancer cells is incompletely understood. Here, we investigated the impact of cisplatin and ZA on viability and metabolism of human cervical cancer cells, known to be bone-metastatic (20,21), as well as sensitive to both these chemotherapeutic agents (22). Furthermore, we evaluated the influence of LLLT on these drugs, testing whether laser irradiation is able to raise the cytotoxicity of cisplatin and ZA by altering cellular metabolism in these cells.…”

Detection of distant metastatic disease by positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) at initial staging of cervical carcinoma

“…The presence of distant metastatic disease portends poor clinical outcomes, with median overall survival of 8 to 13 months 2. The patterns of spread of metastatic cervical cancers have been described in a number of autopsy studies.…”