Zagouri F, Linardou H, Dimopoulos A M, Papadimitriou C A
Department of Clinical Therapeutics, Alexandra Hospital, University of Athens School of Medicine, Athens, Greece.
Eur J Gynaecol Oncol. 2009;30(5):483-92.
Uterine sarcomas constitute a rare group of neoplasms characterized by an aggressive clinical course and poor prognosis. It is this rarity that has resulted in clinical-trial reports and literature reviews including a broad range of histological subtypes of sarcoma. This has a detrimental effect on interpretation and application of the results; the pathological subtype demands a tailored approach. Surgical resection remains the mainstay of treatment for non metastatic uterine sarcomas. Although adjuvant radiation therapy has reportedly been of little survival value, it appears to improve local control and may delay recurrence. The role of adjuvant chemotherapy has yet to be established; however, bearing in mind the limitations and assumptions in the pooling of data the therapeutic options should be based on the pathological subtype. Considering the poor overall survival in uterine sarcomas, the need for new therapeutic agents is critical. New drugs with possible activity in uterine sarcomas include trabectedin, temozolomide, liposomal doxorubicin and gemcitabine.
子宫肉瘤是一组罕见的肿瘤，其临床病程具有侵袭性，预后较差。正是这种罕见性导致临床试验报告和文献综述涵盖了广泛的肉瘤组织学亚型。这对结果的解释和应用产生了不利影响；病理亚型需要采用针对性的方法。手术切除仍然是非转移性子宫肉瘤的主要治疗方法。尽管据报道辅助放疗对生存率的提高作用不大，但它似乎能改善局部控制并可能延缓复发。辅助化疗的作用尚未确立；然而，考虑到数据汇总中的局限性和假设，治疗选择应基于病理亚型。鉴于子宫肉瘤的总体生存率较低，新型治疗药物的需求至关重要。可能对子宫肉瘤有活性的新药包括曲贝替定、替莫唑胺、脂质体阿霉素和吉西他滨。
