Mehri Jafari Shobeiri, Associate Professor, Department of Gynecologic Oncology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Parvin Mostafa Gharabaghi, Associate Professor, Department of Gynecologic Oncology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Pak J Med Sci. 2013 Apr;29(2):651-5. doi: 10.12669/pjms.292.3280.
The aim of this study was to evaluate fertility-sparing therapy in young patients with endometrial carcinoma.
This prospective study was carried out on 8 patients with clinical and radio-graphic stage IA, well differentiated endometrioid adenocarcinoma of the endometrium in Alzahra hospital, Tabriz, Iran. Treatment comprised high-dose megestrol acetate. Dilatation and curettage was repeated every three months.
The mean age of the patients was 30 (SD,3.21) years (range 24-35). Of the 8 patients, 7 (87.5%) achieved complete response. The mean time to response was 6.5 months (range 3-9). Of the complete responders, 3 of 7(42.8%) had recurrence; one patient underwent immediate hysterectomy, and 2 were successfully treated with second-line therapy and both subsequently conceived. Conception occurred in 3 of 7 patients (42.8%), in two more than once, However successful pregnancy occurred only in two patients. One patient developed Concomitant ovarian adenocarcinoma.
High dose progestin therapy can be an effective fertility-sparing treatment in young patients with well differentiated stage IA endometrial endometrioid cancer confined to endometrium. However, close follow up is required because of risks of conservative treatment.
本研究旨在评估子宫内膜癌年轻患者的保留生育功能治疗。
这项前瞻性研究在伊朗大不里士 Alzahra 医院对 8 名患有临床和影像学 IA 期、分化良好的子宫内膜内异腺癌的患者进行。治疗包括大剂量甲地孕酮。刮宫每 3 个月重复一次。
患者的平均年龄为 30 岁（标准差为 3.21）（范围为 24-35）。8 名患者中，7 名（87.5%）完全缓解。达到缓解的平均时间为 6.5 个月（范围为 3-9）。在完全缓解者中，7 名中的 3 名（42.8%）复发；1 名患者立即接受了子宫切除术，2 名患者成功接受了二线治疗，随后均成功怀孕。7 名患者中有 3 名（42.8%）怀孕，其中 2 名不止一次怀孕，但只有 2 名成功怀孕。1 名患者并发卵巢腺癌。
对于局限于子宫内膜的分化良好的 IA 期子宫内膜内异腺癌年轻患者，大剂量孕激素治疗可以是一种有效的保留生育功能治疗方法。然而，由于保守治疗的风险，需要密切随访。
