子宫内膜癌的化疗与内分泌治疗

Chemotherapy and hormonal therapy for endometrial cancers

文章总结了子宫内膜癌术后辅助化疗、术前新辅助化疗和内分泌治疗等问题。术后辅助化疗主要用于晚期子宫内膜癌及早期患者术后具有高危因素的病例。铂与紫杉醇联合应用是目前子宫内膜癌辅助治疗的首选方案。新辅助化疗主要应用于晚期病例,以使随后的减瘤术顺利完成。内分泌治疗虽然没有得到肯定,但是在晚期病例经常用到。

The objective of this essay is to conduct a critical appraisal of the published literature and clinical practices on the use of adjuvant chemotherapy and neo-adjuvant chemotherapy in the treatment of endometrial cancers. Chemotherapy is often recommended for high-risk subsets of stage Ⅰ disease. Level Ⅰevidence exists for use of adjuvant chemotherapy in stage Ⅲ c endometrial cancer,although results of randomized trials have trials. Carboplatin plus paclitaxel is the current standard regimen,based on extrapolation of data from the metastatic setting. Neoadjuvant chemotherapy is performed followed by interval debulking for patients with poor performance status or those patients who the surgeon believes will have suboptimal debulking if surgery is attempted.Although hormonal therapy is not recommended in the adjuvant setting,it remains useful in the treatment of metastatic disease,particularly for tumors of low-grade endometrioid histology with a long time to recur.