Schäfer U, Micke O, Witteler R, Willich N
Klinik und Poliklinik für Strahlentherapie--Radioonkologie, Westfälische n Wilhelms-Universität Münster.
Strahlenther Onkol. 1996 Apr;172(4):205-10.
Cancer of the fallopian tube is one of the rarest gynecological malignancies. The treatment of choice for this tumor is not well defined because of its very low incidence. The preferred primary treatment is surgical resection consisting of abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy. The value and extent of adjuvant radiotherapy is unclear so far. This retrospective analysis shows the experience at our clinic, which will be discussed in comparison with the existing literature.
From 1967 to 1994, 9 patients were treated at the Clinic and Polyclinic for Radiotherapy--Radio-Oncology of the University of Münster with adjuvant radiotherapy following surgery for carcinoma of the fallopian tube. The staging according to FIGO yielded 2/9 stage I, 4/9 stage II and 3/9 stage III patients. In 5/9 patients the tumor could be resected completely. In 3/9 cases the pelvis alone, in 5/9 cases the pelvis and para-aortal region were irradiated with doses ranging from 45 Gy to 50 Gy. In 1/9 cases the target volume comprised the whole abdomen. The treatment results were acquired retrospectively by analysis of the patients' records and inquiries among their general practitioners.
Median survival of our patients was 25 months, 6/9 developed recurrence after a median time of 10.5 months. All of these were localized in the abdominal cavity; 1 patient also developed liver metastases. All patients with recurrent tumor died from their disease within a median period of 9 months. Of the other 3/9 patients, 2/3 died after 6 and 36 months, and 1 patient is still alive after 42 months; all of them without any sign of recurrence.
Adjuvant radiotherapy of carcinoma of the fallopian tube seems to be indicated with the exception of little invasive tumors of FIGO stage I. From our findings, the target volume should comprise the whole abdomen. A smaller treatment volume (pelvis alone or plus the para-aortal region) can only be of any use in a palliative situation or as a salvage therapy.
输卵管癌是最罕见的妇科恶性肿瘤之一。由于其发病率极低，该肿瘤的首选治疗方法尚未明确界定。首选的主要治疗方法是手术切除，包括经腹子宫切除术、双侧输卵管卵巢切除术和大网膜切除术。迄今为止，辅助放疗的价值和范围尚不清楚。这项回顾性分析展示了我们诊所的经验，并将与现有文献进行比较讨论。
1967年至1994年期间，明斯特大学放射治疗——放射肿瘤学诊所及综合诊疗所对9例输卵管癌患者进行了术后辅助放疗。根据国际妇产科联盟（FIGO）分期，9例患者中有2例为I期，4例为II期，3例为III期。9例患者中有5例肿瘤可完全切除。9例中有3例仅对盆腔进行了照射，5例对盆腔和腹主动脉旁区域进行了照射，剂量范围为45 Gy至50 Gy。9例中有1例的靶区包括整个腹部。通过分析患者记录并向其全科医生询问，回顾性地获得了治疗结果。
我们患者的中位生存期为25个月，9例中有6例在中位时间10.5个月后出现复发。所有复发均局限于腹腔；1例患者还出现了肝转移。所有复发肿瘤患者在中位9个月内死于该疾病。其他9例中有3例，其中2例分别在6个月和36个月后死亡，1例在42个月后仍存活；他们均无任何复发迹象。
除FIGO I期微侵袭性肿瘤外，输卵管癌辅助放疗似乎是必要的。根据我们的研究结果，靶区应包括整个腹部。较小的治疗范围（仅盆腔或加腹主动脉旁区域）仅在姑息治疗或挽救治疗中有用。
