孕激素或左炔诺孕酮宫内缓释系统治疗子宫内膜癌的疗效分析

Clinical analysis of progesterone or levonorgestrel intrauterine system on endometrial cancer

目的:探讨孕酮或左炔诺孕酮宫内缓释系统(Progesterone-IUS或LNG-IUS)治疗子宫内膜癌的方案、临床疗效和安全性。方法:收集2002年1月至2012年6月国内外杂志公开发表的Progesterone-IUS或LNG-IUS与子宫内膜癌相关的个案报道共41例。分析单用Progesterone-IUS,LNG-IUS及LNG-IUS联合口服孕激素治疗子宫内膜癌的有效率、安全性。结果:Progesterone-IUS治疗的12例G1ⅠA期子宫内膜癌病例,6个月后治疗有效率为63.6%,12个月时有效率为75%。LNG-IUS治疗的24例病例中,13例单用LNG-IUS,治疗有效率38.5%;LNG-IUS联合口服孕激素11例,有效率为81.8%;13例年龄<40岁,治疗有效率76.9%;11例≥40岁,有效率36.4%。结论:单用Progesterone-IUS或LNG-IUS治疗早期子宫内膜癌有一定疗效,LNG-IUS联合口服孕激素可提高有效率,但存在风险。

Objective：To analyze the clinical efficacy and safety of progesterone or levonorgestrel intrauterine system （Progesterone-IUS or LNG-IUS） on endometrial cancer. Methods：An analysis of 41 cases published from Jan. 2002 to June 2012 was conducted. Re- suits：The effective rates of 12 cases of G1 I A endometrial cancer treated by progesterone relea- sing intrauterine system were 63.6% and 75% by 6 months and 12 months. Among 24 cases treated by LNG-IUS ,the response rates of single LNG-IUS group and LNG-IUS combining oral progestin group were 38.5% and 81.8%. Therapy effective rates in the 〈40 years and I〉40 years old were 76.9% and 36.4% respectively. Conclusions： Progesterone or levonorgestrel in- trauterine system （LNG-IUS） treatment of early stage endometrial cancer has a certain effect. LNG-IUS combining progesterone orally can improve efficiency. At the same time there is still a risk during the treatment.