Pelvic recurrence following radiotherapy for cervical cancer presents a major therapeutic challenge with historically poor prognosis and limited options. This review comprehensively examines the evolving landscape of management strategies for this condition, encompassing both local and systemic approaches. We discuss the roles of salvage surgery and advanced re-irradiation techniques, including stereotactic body radiotherapy and image-guided brachytherapy, highlighting their potential and associated toxicities. A significant focus is placed on the revolution in systemic therapy, particularly the integration of targeted agents—such as anti-angiogenic drugs, PARP inhibitors, and tyrosine kinase inhibitors—and immunotherapy, chiefly immune checkpoint inhibitors like pembrolizumab and cemiplimab. These modalities have demonstrated substantial improvements in survival outcomes in clinical trials. The review underscores the critical shift towards personalized medicine, where treatment selection is increasingly guided by molecular profiling. Finally, we explore future directions, including combination strategies, novel immunotherapies, and emerging technologies, which collectively promise to transform the management of recurrent cervical cancer from palliative control towards the goals of durable remission and functional cure.
宫颈癌放疗后盆腔复发是临床治疗中的重大挑战，其预后历来较差且治疗选择有限。本文全面审视了针对该病症管理策略的发展现状，涵盖局部与全身性治疗方案。我们探讨了挽救性手术与先进再照射技术（包括立体定向体部放疗和影像引导近距离治疗）的作用，重点分析其治疗潜力及相关毒性。本文着重关注全身治疗领域的革命性进展，特别是靶向药物（如抗血管生成药物、PARP抑制剂和酪氨酸激酶抑制剂）与免疫治疗（主要是以帕博利珠单抗和西米普利单抗为代表的免疫检查点抑制剂）的整合应用。临床试验表明，这些治疗模式显著改善了患者的生存结局。本综述强调了个体化医疗的关键转变——分子谱分析正日益成为治疗方案选择的重要依据。最后，我们探讨了未来发展方向，包括联合治疗策略、新型免疫疗法及新兴技术，这些进展共同预示着复发性宫颈癌的治疗目标将从姑息控制转向实现持久缓解与功能性治愈。
Treatment of Pelvic Recurrence After Radiotherapy for Cervical Cancer
肿瘤(癌症)患者之家