Niwa Kuniaki, Kometani Kunio, Sekiya Takao, Nakazawa Kazumi, Kanakura Yoichi
Department of Obstetrics and Gynecology, Fujita Health University, Banbuntane Houtokukai Hospital, Nagoya, Japan.
Int J Clin Oncol. 2002 Jun;7(3):197-200. doi: 10.1007/s101470200029.
Endometrial cancer is believed to have a better prognosis than cervical cancer. However, this is not necessarily true for cases beyond International Federation of Gynecology and Obstetrics (FIGO) stage III, and advanced endometrial cancer with distant metastases in particular has a poor prognosis. Moreover, there is no established therapy for advanced endometrial cancer. Recently, we treated two patients with endometrial cancer with multiple lung metastases (FIGO stage IVb). Both patients had massive uncontrollable genital bleeding and eventually progressed to anemia. The imminent severe bleeding was considered to be a major reason for exacerbation of their general condition. Therefore, hysterectomy was performed as a counter-measure to improve their general condition. In their postoperative course, the two patients successfully underwent T-J chemotherapy [paclitaxel: 210 m/m2 over 3h; carboplatin: area under the curve (AUC) 5]. Six courses of the regimen were given every 3-4 weeks. Multiple lung shadows in chest X-P and computed tomography (CT) were reduced in number and size after two courses of T-J chemotherapy. The multiple lung metastases either disappeared or just remained as scars after six courses. There has been no evidence of recurrence for 28 months in one patient and 7 months in the other patient.
子宫内膜癌被认为比宫颈癌预后更好。然而,对于国际妇产科联盟(FIGO)III期以上的病例,情况未必如此,尤其是伴有远处转移的晚期子宫内膜癌预后较差。此外,晚期子宫内膜癌尚无既定的治疗方法。最近,我们治疗了两名患有多发性肺转移的子宫内膜癌患者(FIGO IVb期)。两名患者均出现大量难以控制的生殖器出血,最终发展为贫血。即将发生的严重出血被认为是其全身状况恶化的主要原因。因此,为改善其全身状况,采取了子宫切除术作为应对措施。在术后过程中,两名患者成功接受了T-J化疗[紫杉醇:210 m/m2静脉滴注3小时;卡铂:曲线下面积(AUC)5]。每3-4周进行六个疗程的治疗。在进行两个疗程的T-J化疗后,胸部X线平片和计算机断层扫描(CT)显示的多发性肺部阴影数量和大小均有所减少。六个疗程后,多发性肺转移灶要么消失,要么仅留下瘢痕。一名患者28个月、另一名患者7个月均无复发迹象。