Sarcoma Unit, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK.
Expert Rev Anticancer Ther. 2012 Jul;12(7):885-94. doi: 10.1586/era.12.74.
Gynecological sarcomas are rare, constituting 3-5% of uterine malignancies. Endometrial stromal sarcomas and some uterine leiomyosarcomas are characterized by estrogen receptor (ER) and progesterone receptor (PgR) expression with variable impact on their clinical behavior and potential response to systemic therapies. A variety of hormonal treatments have been tested, since they act as targeted treatment against ER and PgR and have a tolerable side effect profile, which allows them to be administered for prolonged periods. Their role has been studied more extensively in endometrial stromal sarcomas, as the majority of cases are ER/PgR positive, while recently, an emerging role for hormonal manipulation has been described in ER/PgR-positive uterine leiomyosarcomas. Owing to the rarity and heterogeneous nature of uterine sarcomas, current treatment recommendations are based on small retrospective studies and case reports. This review comprises a critical appraisal of the existing data regarding hormonal manipulation in uterine sarcomas and attempts to make recommendations for endocrine treatments in specific settings, as well as suggest targets/medications for future research.
妇科肉瘤较为罕见，占子宫恶性肿瘤的 3-5%。子宫内膜间质肉瘤和部分子宫平滑肌肉瘤的特征是雌激素受体 (ER) 和孕激素受体 (PgR) 的表达，这对其临床行为和潜在的系统治疗反应有一定影响。由于它们针对 ER 和 PgR 起靶向治疗作用，且副作用可耐受，允许长期使用，因此已对其进行了多种激素治疗方法的测试。在子宫内膜间质肉瘤中，它们的作用已得到更广泛的研究，因为大多数病例为 ER/PgR 阳性，而最近，激素处理在 ER/PgR 阳性的子宫平滑肌肉瘤中的作用也逐渐显现。由于子宫肉瘤的罕见性和异质性，目前的治疗建议基于小型回顾性研究和病例报告。本综述对激素处理在子宫肉瘤中的现有数据进行了批判性评估，并尝试针对特定情况下的内分泌治疗提出建议，同时为未来的研究提出目标/药物。
