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早期子宫内膜癌的辅助治疗——谁从放射治疗中获益最大?

Adjuvant therapy for early endometrial cancer - who benefits the most from a radiation therapy?

作者信息

Michalak Marcin, Warenczak Florczak Zaneta, Staszewska-Nowak Agnieszka, Roszak Andrzej

机构信息

Greater Poland Cancer Centre, Poznan, Poland.

出版信息

Ginekol Pol. 2020;91(1):6-12. doi: 10.5603/GP.2020.0003.

Abstract

OBJECTIVES

Since 1990s the number of patients diagnosed with endometrial cancer (EC) has doubled. The standard treatment method for treating early endometrial cancer is surgery. Some patients require a subsequent adjuvant therapy. In early endometrial cancers its application is limited to the populations with a high risk of recurrence. The aim of this study was to assess the effectiveness of early endometrial cancer treatment based on an analysis of 5-year follow up of EC patients.

MATERIAL AND METHODS

The analysis consisted in a retrospective non-randomized interventional study of patients treated for early endometrial cancer (FIGO stage IA, IB, II). Its end point was either local (small pelvis) or distant recurrence of the disease. Intervention involved an adjuvant treatment applied in selected patients according to the current guidelines for EC treatment. There was no randomization for adjuvant and non-adjuvant EC treatment. The study included a total of 419 patients treated for EC from 2010 to 2012.

RESULTS

The analysis revealed that 108 patients (25.8%) were diagnosed with the recurrent disease. Out of 112 patients treated for stage IA endometrial cancer 32 (28.6%) experienced recurrence. Out of 216 patients at FIGO Stage IB, recurrence was diagnosed in 38 (17.6%). In the group of 91 patients treated for FIGO stage II, EC the recurrence was diagnosed in 38 (41.2%) cases.

CONCLUSIONS

Early EC treatment results were unsatisfactory and should be improved. The best outcomes were achieved in patients with IA stage of EC who received a radiation therapy.

摘要

目的

自20世纪90年代以来,被诊断为子宫内膜癌(EC)的患者数量翻了一番。早期子宫内膜癌的标准治疗方法是手术。一些患者需要后续的辅助治疗。在早期子宫内膜癌中,其应用仅限于复发风险高的人群。本研究的目的是通过对EC患者5年随访分析来评估早期子宫内膜癌治疗的有效性。

材料与方法

该分析包括一项对早期子宫内膜癌(国际妇产科联盟(FIGO)分期IA、IB、II期)患者进行的回顾性非随机干预研究。其终点是疾病的局部(小骨盆)或远处复发。干预措施包括根据当前EC治疗指南对选定患者进行辅助治疗。辅助治疗和非辅助治疗EC没有随机分组。该研究共纳入了2010年至2012年期间接受EC治疗的419例患者。

结果

分析显示,108例患者(25.8%)被诊断为疾病复发。在112例接受IA期子宫内膜癌治疗的患者中,32例(28.6%)出现复发。在FIGO IB期的216例患者中,38例(17.6%)被诊断为复发。在91例接受FIGO II期EC治疗的患者组中,38例(41.2%)被诊断为复发。

结论

早期EC治疗效果不理想,应予以改善。IA期EC患者接受放射治疗取得了最佳疗效。

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