Jazy F K, Shehata W M, Dobrogorski O J, Alamin K, Schmidt R T
Clin Oncol. 1983 Dec;9(4):281-8.
A retrospective analysis of 180 cases with clinical stage I endometrial carcinoma was done in an attempt to determine the role of pre- versus postoperative irradiation (RT). One hundred and forty-eight patients were treated pre-operatively and 32 patients received postoperative irradiation. The incidence of middle and outer 1/3 myometrial invasion was 7% and 4% in the pre-operative RT versus 28% and 31% in the postoperative RT group, respectively. Three percent of the pre-operative RT group and 28% of the post-operative RT patients were found to have a higher pathological stage at the time of hysterectomy. The overall five year actuarial survival rate in the pre- and postoperative irradiation groups was 88% and 75% (p = 0.128) respectively. The 10 year survival in the pre-operative RT group was 84% versus 51% (p = 0.056) in the postoperative RT patients. There was a significant improvement (p = 0.006) in ten year actuarial survival of patients with hysterectomy specimen free of malignancy (97%) as compared to (70%) survival of patients with residual diseases. The overall failure rate was lower (9%) in the pre-operative RT as compared to 28% in the postoperative RT group (p = 0.02) with pelvic recurrences of 2% and 13%, respectively (p = 0.01). The major complication rate was 3% in the pre-operative RT versus none in the postoperative RT group. The rate of complications correlated with the dose and technique of irradiation. Our results suggest that pre-operative irradiation decreases the depth of myometrial invasion and the rate of pelvic recurrences, lowers the pathological stage and probably increases the survival compared with postoperative irradiation.
对180例临床I期子宫内膜癌患者进行回顾性分析，以确定术前与术后放疗（RT）的作用。148例患者接受术前治疗，32例患者接受术后放疗。术前放疗组子宫肌层中外1/3浸润的发生率分别为7%和4%，而术后放疗组分别为28%和31%。术前放疗组3%的患者和术后放疗组28%的患者在子宫切除时病理分期较高。术前和术后放疗组的总体五年精算生存率分别为88%和75%（p = 0.128）。术前放疗组的10年生存率为84%，而术后放疗患者为51%（p = 0.056）。与有残留疾病患者的生存率（70%）相比，子宫切除标本无恶性肿瘤患者的10年精算生存率有显著提高（p = 0.006）（97%）。术前放疗组的总体失败率较低（9%），而术后放疗组为28%（p = 0.02），盆腔复发率分别为2%和13%（p = 0.01）。术前放疗组的主要并发症发生率为3%，而术后放疗组无并发症。并发症发生率与放疗剂量和技术相关。我们的结果表明，与术后放疗相比，术前放疗可降低子宫肌层浸润深度和盆腔复发率，降低病理分期，并可能提高生存率。
