Women and Infants' Hospital, The Warren Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905, USA.
Gynecol Oncol. 2010 May;117(2):373-81. doi: 10.1016/j.ygyno.2010.02.007. Epub 2010 Mar 12.
Endometrial carcinoma is the most common malignancy of the female reproductive tract. Most cases are diagnosed at an early stage due to the appearance of symptoms such as postmenopausal bleeding. However, endometrial carcinoma carries a poor prognosis when it recurs after previous definitive treatment or when diagnosed at an advanced stage. Here, treatment options for advanced endometrial carcinoma are evaluated.
Literature review was performed to determine current therapy options, with a focus on the treatment landscape for women with recurrent, advanced, or metastatic disease.
Combination chemotherapy is being used more frequently as first-line treatment of advanced disease, consisting of cisplatin/doxorubicin/paclitaxel, if tolerated, or the doublet of carboplatin/paclitaxel. Options following disease progression after first-line treatment are extremely limited, particularly with the increasing use of active agents in the adjuvant setting. Fortunately, several new cytotoxic and biologic therapies appear promising for women who have progressed on first-line treatment.
Clinical trials are planned to further explore how to best incorporate novel agents into the current treatment algorithm with the aim to improve the options in both first- and second-line treatments for women with endometrial adenocarcinomas.
子宫内膜癌是女性生殖道最常见的恶性肿瘤。由于绝经后出血等症状的出现,大多数病例在早期被诊断出来。然而,在先前明确治疗后复发或在晚期诊断时,子宫内膜癌的预后较差。本文评估了晚期子宫内膜癌的治疗选择。
对文献进行了回顾,以确定当前的治疗选择,重点是针对复发、晚期或转移性疾病的女性的治疗现状。
联合化疗越来越多地被用作晚期疾病的一线治疗方法,如果可以耐受,联合化疗方案包括顺铂/多柔比星/紫杉醇,或者卡铂/紫杉醇的双联方案。在一线治疗后疾病进展后的选择极为有限,特别是在辅助治疗中越来越多地使用有效的药物。幸运的是,对于一线治疗后进展的女性,几种新的细胞毒性和生物治疗药物似乎很有前途。
计划开展临床试验,进一步探讨如何将新型药物最佳地纳入当前治疗方案,旨在改善子宫内膜腺癌女性在一线和二线治疗中的选择。