子宫肉瘤术后辅助治疗102例临床观察

Clinical Study of Adjuvant Therapy in 102 Cases with Uterine Sarcoma

[目的]探讨子宫肉瘤术后辅助治疗的疗效。[方法]回顾性分析102例子宫肉瘤,其中单纯手术25例,术后放疗23例,术后化疗32例,术后放化疗22例。[结果]5年生存率单纯手术组为32.0%,术后放疗组34.7%,术后化疗组31.2%,术后放化疗组36.4%;盆腔复发和远处转移率单纯手术组分别为48%和36%,术后放疗组为34%和30.4%,术后化疗组为40.6%和28.1%,术后放化疗组为31.8%和27.3%。总5年生存率为33.3%。[结论]子宫肉瘤术后辅助放疗可减少盆腔复发,辅以化疗可延缓和降低远处转移,两者均可提高无瘤生存率,但不能提高总的生存率。

To study the effect of adjuvant therapy in uterine sarcomas. Treatment of 102 cases with uterine sarcoma was retrospectively analyzed. Twenty-five cases were treated with surgery alone, 23 with postoperative radiotherapy, 32 with postoperative chemotherapy, and 22 with surgery and chemo-radiation. The 5-year survival rates of patients treated with surgery alone, with postoperative radiotherapy, with postoperative chemotherapy, with surgery and chemo-radiation were 32.0%, 34.7%, 31.2%, 36.4% respectively. The pelvic recurrence and metastatic rate in patients with surgery alone were 48% and 36%, 34% and 30.4% in patients with postoperative radiotherapy, 40.6% and 28.1% in patients with postoperative chemotherapy, and 31.8% and 27.3% in patients with postoperative combination of chemo-radiation respectively. The overall 5-year survival rate was 33.3%. [Conclusion] Postoperative radiotherapy can improve local control, and adjuvant chemotherapy can decrease metastases. Both of them can improve disease-free survival rate, but can not improve overall survival rate for uterine sarcoma.