Ihnen M, Mahner S, Jänicke F, Schwarz J
Klinik und Poliklinik für Gynäkologie, Universitätsklinikums Hamburg-Eppendorf, Hamburg, Germany.
Int J Gynecol Cancer. 2007 Sep-Oct;17(5):957-63. doi: 10.1111/j.1525-1438.2007.00889.x. Epub 2007 Mar 13.
Uterine sarcomas are a rare form of uterine cancer. They occur in women from 40 to 60 years and are generally characterized by poor prognosis, a high rate of local recurrence, and distant metastases. Endometrial stromal sarcoma (ESS) accounts for 0.2% of all gynecological malignancies. Forms of possible treatment include surgery, radiotherapy, chemotherapy, and endocrine treatment. Randomized trials analyzing these treatment options are limited due to the rarity of this disease; therefore, a standard therapy could not be established thus far. To present an overview of the current treatment options of ESS, a search of Medline, Embase, and the Cochrane Library was performed and the results concluded. We report the case of a 32-year-old woman who presented with FIGO stage II ESS. Initial treatment with tamoxifen and local perfusion with cisplatin resulted in disease progression and were discontinued. A novel, therapeutic approach using two cycles of combination chemotherapy with doxorubicin and ifosfamide followed by surgery was applied. Five years after surgery, the patient is still in complete remission. Thus, we conclude that although there is no data from randomized trials available, chemotherapy in advanced or metastatic ESS can provide an opportunity for surgical treatment and can lead to long-term remission.
子宫肉瘤是一种罕见的子宫癌形式。它发生于40至60岁的女性，通常具有预后差、局部复发率高和远处转移的特点。子宫内膜间质肉瘤（ESS）占所有妇科恶性肿瘤的0.2%。可能的治疗方式包括手术、放疗、化疗和内分泌治疗。由于这种疾病罕见，分析这些治疗选择的随机试验有限；因此，目前尚未确立标准治疗方案。为了概述ESS目前的治疗选择，我们检索了Medline、Embase和Cochrane图书馆并总结了结果。我们报告了一例32岁患有国际妇产科联盟（FIGO）II期ESS的女性病例。最初使用他莫昔芬治疗并局部灌注顺铂导致疾病进展，随后停止治疗。我们采用了一种新的治疗方法，即先用两个周期的阿霉素和异环磷酰胺联合化疗，然后进行手术。术后五年，患者仍处于完全缓解状态。因此，我们得出结论，尽管没有来自随机试验的数据，但晚期或转移性ESS的化疗可为手术治疗提供机会，并可导致长期缓解。
