Wong L, See H T, Khoo-Tan H S, Low J S, Ng W T, Low J J
KK Women's and Children's Hospital, Singapore.
Int J Gynecol Cancer. 2006 May-Jun;16(3):1364-9. doi: 10.1111/j.1525-1438.2006.00560.x.
The role of adjuvant therapy for malignant mixed müllerian tumors of the uterus has not been established. Our aim was to review our experience with sequential adjuvant therapy using cisplatin and ifosfamide chemotherapy and radiotherapy after surgical staging. A retrospective study of 43 patients from 1995 to 2004 was undertaken. Survival was calculated using the Kaplan-Meier method and compared by the log-rank test. The Cox proportional hazard regression model was used to assess the effect of treatment on survival after adjustment for age and stage. Twenty-eight patients received adjuvant chemotherapy and 28 patients had adjuvant radiotherapy. Twenty-one patients underwent sequential adjuvant chemotherapy and radiotherapy. Tumor recurrence occurred in 14 patients at a median duration of 10 months. The overall 2- and 5-year survival was 64% and 60%, respectively. The 2- and 5-year survival for stage I and II diseases was both 95%, while the 2-year survival for stage III and IV diseases was 25%. Patients who underwent sequential adjuvant therapy had an improved survival compared with patients who did not follow the protocol (P= 0.024). Our results with sequential adjuvant therapy are encouraging and justify future randomized trials.
子宫恶性混合性苗勒管肿瘤辅助治疗的作用尚未明确。我们的目的是回顾我们在手术分期后序贯使用顺铂和异环磷酰胺化疗及放疗进行辅助治疗的经验。对1995年至2004年的43例患者进行了回顾性研究。采用Kaplan-Meier方法计算生存率，并通过对数秩检验进行比较。使用Cox比例风险回归模型评估在调整年龄和分期后治疗对生存的影响。28例患者接受了辅助化疗，28例患者接受了辅助放疗。21例患者接受了序贯辅助化疗和放疗。14例患者出现肿瘤复发，中位复发时间为10个月。总体2年和5年生存率分别为64%和60%。I期和II期疾病的2年和5年生存率均为95%，而III期和IV期疾病的2年生存率为25%。接受序贯辅助治疗的患者与未遵循方案的患者相比，生存率有所提高（P = 0.024）。我们序贯辅助治疗的结果令人鼓舞，为未来的随机试验提供了依据。
