Champetier C, Hannoun-Levi J-M, Resbeut M, Azria D, Salem N, Tessier E, Ellis S, Cowen D
Service de Radiothérapie, Hôpital de la Timone, 264 Rue Saint-Pierre, 13385 Marseille cedex 05, France.
Cancer Radiother. 2011 Apr;15(2):89-96. doi: 10.1016/j.canrad.2010.05.005. Epub 2010 Jul 31.
Surgery is the treatment of choice for localized uterine sarcomas. We conducted a retrospective study to define prognostic factors.
We studied 111 cases of patients treated by adjuvant radiotherapy for uterine sarcoma in seven French centers. The median decline was 31 months. We conducted a univariate analysis to identify factors correlated with local recurrence. The statistically significant factors were studied in multivariate analysis by Cox model.
The median dose of external beam radiotherapy was 45 Gy. Forty-three percent of patients had vaginal vault brachytherapy and 21 % chemotherapy. Only 6.3 % of patients had complications of acute grade III and 8.1 % of long-term sequelae of radiotherapy. The survival rate at 5 years was 74.6 %. They noted 12.6 % of isolated locoregional recurrences, against 29.7 % for distant recurrences, 80 % were pulmonary. Factors correlated with the risk of locoregional relapse were menopausal status (P = 0.045) and surgical margins suspicious or not healthy (P = 0.0095). The chemotherapy did not improve overall survival or disease free survival but the numbers were low.
The postoperative radiotherapy provides good local control in this disease. Brachytherapy is sometimes done, but it does not improve local control. Chemotherapy is not a standard localized stage but the rate of metastatic recurrence calls for the development of strategies involving systemic treatment with radiotherapy.
手术是局限性子宫肉瘤的首选治疗方法。我们进行了一项回顾性研究以确定预后因素。
我们研究了法国七个中心接受子宫肉瘤辅助放疗的111例患者。中位随访时间为31个月。我们进行单因素分析以确定与局部复发相关的因素。通过Cox模型对具有统计学意义的因素进行多因素分析。
外照射放疗的中位剂量为45 Gy。43%的患者接受了阴道穹隆近距离放疗，21%接受了化疗。仅6.3%的患者出现急性3级并发症，8.1%出现放疗的长期后遗症。5年生存率为74.6%。他们注意到孤立的局部区域复发率为12.6%，远处复发率为29.7%，其中80%为肺转移。与局部区域复发风险相关的因素是绝经状态（P = 0.045）和手术切缘可疑或不健康（P = 0.0095）。化疗并未改善总生存期或无病生存期，但病例数较少。
术后放疗对该疾病提供了良好的局部控制。有时会进行近距离放疗，但它并未改善局部控制。化疗并非局限性分期的标准治疗，但转移复发率促使制定涉及放疗的全身治疗策略。
