Pernot M, Hoffstetter S, Peiffert D, Guillemin F, Carolus J M, Verhaeghe J L, Luporsi E, Beckendorf V
Centre Alexis Vautrin, Vandoeuvre les Nancy, France.
Strahlenther Onkol. 1994 Jun;170(6):313-21.
Surgery is the golden standard of treatment of endometrial carcinoma. The risk of central or vaginal recurrences justifies adjuvant treatment.
Brachytherapy for endometrial adenocarcinoma is given commonly as pre- or post-operative treatment. In case of medical contra-indications for surgery brachytherapy can be applied as the only treatment. Experience of the anticancer center Alexis Vautrin in Nancy of the years 1975 to 1988 is evaluated. Iridium-192 low-dose-rate (LDR) wires were used.
Pre-operative brachytherapy was given with a vaginal mould applicator to 580 patients. The dose was 50 Gy at 0.5 cm below the surface of the vagina. The locoregional control rate was 93% after 5 years and the 5-year survival 82%. 139 patients received radiotherapy alone and no surgery. LDR-brachytherapy was given the upper third of the vagina and endometrium with an "umbrella" applicator. The locoregional control rate was 83% after 5 years and the survival rate 55%. 117 patients received a post-operative brachytherapy of the vagina. The locoregional control rate was 93% after 10 years and the survival rate 65%.
A pre- and post-operative radiotherapy results in a reduction of the vaginal relapse rate. The LDR afterloading technique with primary radiotherapy of endometrial adenocarcinoma leads to a locoregional control slightly interior. The treatment results compare favourably with the best of the literature.
手术是子宫内膜癌治疗的金标准。中央或阴道复发风险使得辅助治疗成为必要。
子宫内膜腺癌近距离放疗通常作为术前或术后治疗。若存在手术的医学禁忌证，近距离放疗可作为唯一治疗方法。对1975年至1988年南锡亚历克西斯·沃特林抗癌中心的经验进行评估。使用铱-192低剂量率（LDR）导线。
580例患者采用阴道模具施源器进行术前近距离放疗。阴道表面以下0.5厘米处剂量为50 Gy。5年后局部区域控制率为93%，5年生存率为82%。139例患者仅接受放疗未进行手术。采用“伞形”施源器对阴道上三分之一和子宫内膜进行LDR近距离放疗。5年后局部区域控制率为83%，生存率为55%。117例患者接受阴道术后近距离放疗。10年后局部区域控制率为93%，生存率为65%。
术前和术后放疗可降低阴道复发率。子宫内膜腺癌初次放疗采用LDR后装技术可实现稍低的局部区域控制。治疗结果与文献中最佳结果相比具有优势。
