Ⅰ期子宫内膜癌术后放疗分析

Clinical analysis of postoperative radiotherapy for stage I endometrial cancer

目的对Ⅰ期子宫内膜癌术后放疗的意义和放射并发症等进行探讨。方法１９８６年５月～１９９５年１２月收治Ⅰ期子宫内膜癌２０例，均经术后病理证实。１５例行子宫全切及双附件切除术，５例加盆腔淋巴结清扫。２０例均行术后放疗，大部分患者术后２～４周开始放疗，照射野包括全部盆腔淋巴结。全盆腔ＤＴ４０～５０Ｇｙ。全部患者得到随访。结果３，５，１０年生存率分别为１０／１０、８／９、３／４，局控率１００％（２０／２０）。５年远转率５％（１／２０）。２０例在放疗过程中均出现不同程度的急性放射并发症，６例有晚期放射并发症，其中２例较严重。结论术后放疗对提高局控率有利，但晚期损伤发病率相对较高。

Objective To evaluate the role and complications of adjuvant radiotherapy for stage I endometrial cancer after surgery. Methods From May, 1986 to December, 1995, 20 patients with stage I endometrial cancer received total abdominal hysterectomy with bilateral salpingo oophorectomy(TAH/BSO), and additional pelvic lymph node dissection in 5 cases. Most of the patients received radio therapy in 2～4 weeks after surgery. The radiation fields included pelvic lymph nodes with a total dose of 40～50 Gy. Results All the patients had survived for 10 years. Only one patient developed distant metastases. Acute radiation reaction was observed in all patients. Late radiation induced damage occured in six patients and was severe in two. Conclusion Postoperative radiotherapy in the management of stage I endometrial cancer is beneficial for the controal of local recur rence but has relatively high frequency of late radiation injury.