子宮癌は頸癌と体癌よりなる.近年頸癌はヒトパピローマウイルス(HPV)が,発癌の要因であることがほぼ確立された.上皮内癌を含めた罹患率は20代で大幅な伸びを示し,性活動の活発化にともなうHPV感染の関与とされ,検診の実施年齢も20歳以上に引き下げられた.欧米では予防ワクチンの大規模臨床試験が進行中である.進行癌でも米国臨床試験の報告から,化学療法併用放射線治療がほぼ標準治療になって来ている.体癌は罹患率が約3倍に増加している.これは高齢者の増加,ライフスタイルの変化による.体癌の治療は手術以外の治療に確立されたものはない,補助療法は欧米では放射線治療,本邦では化学療法が一般的である.まだ中間解析の報告ではあるが,進行癌での比較試験では,化学療法群が無病生存率,最終生存率いずれにおいても化学療法の優位が報告された.現在,頸癌,体癌とも日本婦人科腫瘍学会が治療ガイドラインを作成中であるが,国内での臨床研究のさらなる基盤整備が必要である.Uterine carcinoma is cervical and endometrial cancer. Recently, epidemiologic studies demonstrate that the major risk factor for development of cervical cancer is HPV infection. Incident rate of cervical cancer has been increasing in twenties. Ministry of health, labour and welfare recommend that official cancer screening tests starts more than twenty. In Europe and America, Randomized phase III control trials of prophylactic vaccine therapy for preventing HPV is doing. Based on clinical trials, concurrent cisplatin-based chemotherapy with radiation has been standard treatment of patient with advanced cervical cancer. Endometrial cancer is increased in change of our Japanese life stile. Operation is only established therapy in patient with endometrial cancer Adjuvant radiation therapy is standard treatment in US. Nevertheless, adjuvant chemotherapy is standard in Japan. A randomized phase III study comparing radiation therapy versus chemotherapy in patient with advanced endometrial cancer is now going. In Preliminary data of this trial, chemotherapy was higher progression free and all over survival rate than radiation therapy. After all, we should be made the guidelines for cervical and endometrial cancer as soon as possible. Thus, we need improvement of the system for clinical trials
