Cervical cancer is the fourth most frequent malignancy in women with high mortality and incidence rate in low-income and middle-income countries. Human papillomavirus infection is linked with approximately 70 % of cases, vaccination and screening for premalignant lesions can lead to 80 % decrease in incidence rate. Therapy in early stages is mostly surgical and sometimes fertility preservation is possible. Radiotherapy with concomitant chemotherapy, preferably cisplatin, is required in locally advanced stages.
Metastasectomy or radiotherapy targeting limited metastatic disease is recommended in suitable cases. Use of bevacizumab combined with chemotherapy became standard in first-line palliative treatment, though it may cause serious adverse effects with major deterioration of patient´s quality of life. Checkpoint inhibitor pembrolizumab is recommended in second-line palliative treatment since 2018. Importance of best supportive care should not be underestimated in cervical cancer diagnosis.
Key words: human papillomavirus, conization, fertility preservation, concomitant chemoradiotherapy, bevacizumab, pembrolizumab.
Lek Obz, 2020, 69 (7 – 8): 264-271
Lucia NOCAROVÁ 1,2, Martina ONDRUŠOVÁ 3, Dalibor ONDRUŠ 1
1 I. onkologická klinika LF UK a OÚSA, Bratislava, prednosta prof. MUDr. D. Ondruš, DrSc.
2 Interná klinika VŠZaSP a OÚSA, Bratislava
3 Pharm-In, spol. s r. o., Bratislava