对于UDCC,应先行盆腹腔CT、磁共振成像(MRI)和胸部扫描,如需要则行全身检查(如PET-CT)来评估病变范围,根据肿瘤的浸润深度及扩散范围进行相应的处理[16]。具体治疗方案如下:(1)ⅠA1期无淋巴脉管浸润,不需进一步处理,可严密观察随诊。(2)ⅠA1期有脉管浸润、ⅠA2期及ⅠA2期以上如切缘阴性且影像学检查未见残留肿瘤,可选择盆腔体外及腔内放疗±同步化疗或者行广泛子宫旁组织切除+阴道上段切除术+盆腔淋巴结切除术±腹主动脉旁淋巴结取样术。如切缘阳性或肉眼可见残留灶,但影像学检查提示无淋巴结转移,予盆腔体外照射,加同步化疗;如阴道切缘阳性则根据具体情况加腔内近距离放疗;如切缘阳性或肉眼可见残留灶,术后予以盆腔体外照射(腹主动脉旁淋巴结阳性则增加延伸野照射)加同步放疗;如阴道切缘阳性则根据具体情况加腔内近距离放疗。
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原始出处: