NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia,
Curr Oncol Rep. 2013 Dec;15(6):541-8. doi: 10.1007/s11912-013-0343-3.
For many years hormonal treatment has played a role in the treatment of a selected group of patients with a variety of recurrent or metastatic gynaecological cancers, including ovarian and endometrial carcinomas, endometrial stromal sarcomas and granulosa cell tumours. Hormonal agents that are typically used include luteinizing-hormone-releasing hormone analogues, progestogens, selective oestrogen-receptor-modulating drugs such as tamoxifen, and more recently aromatase inhibitors. The rates of response to these drugs differ considerably depending on the tumour type, disease grade and stage as well as the type of drug used. Patients with granulosa cell tumours and endometrial stromal sarcomas have the highest response rates; owing to the rarity of these tumour types, the documented response rates are based on case reports and small series. Response rates in patients with recurrent and metastatic endometrial and ovarian carcinoma have been lower. It has been suggested that patients with well-differentiated and hormone-receptor-positive carcinomas are more likely to benefit from hormonal treatment. However, the data to support this are limited, and at times conflicting, with very few prospective studies to date. This review updates the evidence for the use of hormonal treatment in patients with potentially hormone responsive recurrent and metastatic gynaecological cancers.
多年来，激素治疗在治疗多种复发性或转移性妇科癌症患者方面发挥了作用，包括卵巢癌和子宫内膜癌、子宫内膜间质肉瘤和颗粒细胞瘤。常用的激素药物包括促黄体激素释放激素类似物、孕激素、选择性雌激素受体调节剂，如他莫昔芬，以及最近的芳香酶抑制剂。这些药物的反应率因肿瘤类型、疾病分级和分期以及所使用的药物类型而有很大差异。颗粒细胞瘤和子宫内膜间质肉瘤患者的反应率最高；由于这些肿瘤类型罕见，有记录的反应率基于病例报告和小系列。复发性和转移性子宫内膜癌和卵巢癌患者的反应率较低。有人认为，分化良好且激素受体阳性的癌症患者更有可能从激素治疗中受益。然而，支持这一观点的数据有限，而且有时相互矛盾，迄今为止很少有前瞻性研究。这篇综述更新了激素治疗在潜在激素反应性复发性和转移性妇科癌症患者中的应用证据。
