Gynecological Department, San Raffaele Hospital, Milan, Italy.
Gynecol Oncol. 2010 Mar;116(3):408-12. doi: 10.1016/j.ygyno.2009.11.019. Epub 2009 Dec 21.
The concurrent use of radiotherapy (RT) and chemotherapy (CT) as adjuvant treatment after surgery in high-risk endometrial cancer has been generally considered cautiously. Recently some of us have reported preliminary data on the efficacy and tolerability of concomitant CT and RT. In this paper, we update our experience.
A total of 47 patients aged >18 years and <80 years with histological diagnosis of high-risk endometrial endometrioid carcinomas entered the study. Inclusion criteria were stages IC G3, IIB, IIIA (patients with positive washing without other unfavourable prognostic factors were omitted), IIIB and IIIC. The radiation plan consisted of a total dose of 50.4 Gy, given in five fractions per week (1.8 Gy: daily dose) for 6 weeks. Paclitaxel (P) at a dose of 60 mg/m(2) was infused intravenously in 250 mL of normal saline for 1 h once weekly during RT for 5 weeks. Three further cycles of Paclitaxel, at a dose of 80 mg/m(2), have been given weekly at the end of RT.
There was no life-threatening toxicity. The overall 5-year relapse-free survival was 81.8% (95% CI, 65.2-90.9). The 5-year percent overall disease-specific survival was 88.4% (95% CI, 71.1-95.6).
These results, based on a larger series, support our previous data: Paclitaxel plus RT may represent an effective and well-tolerated treatment in high-risk endometrial cancer patients.
手术后辅助放化疗（RT 和 CT）在高危子宫内膜癌中的联合应用一直被谨慎考虑。最近我们中的一些人报告了同期 CT 和 RT 的疗效和耐受性的初步数据。在本文中，我们更新了我们的经验。
共有 47 名年龄> 18 岁且<80 岁的组织学诊断为高危子宫内膜内膜样癌的患者入组本研究。纳入标准为 IC G3 期、IIB 期、IIIA 期（排除有阳性冲洗而无其他不良预后因素的患者）、IIIB 期和 IIIC 期。放射计划包括总剂量 50.4 Gy，每周 5 次，每次 1.8 Gy（每日剂量），共 6 周。紫杉醇（P）剂量为 60 mg/m2，在 RT 期间每周一次，共 5 周，用 250 mL 生理盐水静脉输注 1 h。RT 结束时每周给予 3 个周期的紫杉醇，剂量为 80 mg/m2。
无危及生命的毒性。总体 5 年无复发生存率为 81.8%（95%CI，65.2-90.9）。5 年总疾病特异性生存率为 88.4%（95%CI，71.1-95.6）。
这些基于更大系列的结果支持我们之前的数据：紫杉醇加 RT 可能是高危子宫内膜癌患者的一种有效且耐受性良好的治疗方法。
