Department of Obstetrics and Gynecology, Women Hospital (Mirza Koochackhan), Tehran University of Medical Sciences, Tehran, Iran.
Arch Gynecol Obstet. 2012 Mar;285(3):791-5. doi: 10.1007/s00404-011-2021-8. Epub 2011 Jul 30.
The most effective treatment of well-differentiated endometrial carcinoma is surgery. The aim of this study is the evaluation of megestrol acetate on young patients with well-differentiated endometrial cancer who wish to preserve their fertility, with regard to the receptors.
16 patients were treated initially with 160 mg/d of megestrol acetate and continued with 320 mg/d for non-responsive cases. All patients followed with FD&C and hysteroscopy. The responsive patients were referred to IVF group.
Response rate to hormonal therapy was 10/16 (62.5%). The mean time of responding was 7.5 months. Other six (37.5%) patients underwent total abdominal hysterectomy (TAH). Of 10 patients who responded to hormonal therapy, one exited of the study because of her husband's infertility. Two patients are under IVF. Three patients did not get pregnant and four patients became pregnant and finally underwent TAH. All patients had progesterone receptors. Only one patient lacked estrogen receptors; who also responded to treatment.
Progestins treatment of these patients who want to have child may be useful, but close long-term follow-up is necessary. The evaluation of estrogen and progesterone receptors assay may be useful in predicting response to the treatment.
对于希望保留生育能力的分化良好的子宫内膜癌年轻患者,手术是最有效的治疗方法。本研究旨在评估醋酸甲地孕酮对这些患者的作用,以受体为观察指标。
16 例患者初始给予醋酸甲地孕酮 160mg/d,无反应者增至 320mg/d。所有患者均行 FD&C 和宫腔镜检查。有反应者转至 IVF 组。
16 例患者中 10 例(62.5%)对激素治疗有反应。反应平均时间为 7.5 个月。其余 6 例(37.5%)行全子宫切除术(TAH)。10 例对激素治疗有反应的患者中,1 例因丈夫不育而退出研究。2 例患者正在接受 IVF。3 例未怀孕,4 例怀孕并最终行 TAH。所有患者孕激素受体阳性。仅 1 例雌激素受体缺乏,也对治疗有反应。
对于希望生育的此类患者,孕激素治疗可能有用,但需要长期密切随访。雌激素和孕激素受体检测有助于预测治疗反应。