子宫内瘤的联合化疗

目的 探讨子宫肉瘤术后及复发肿瘤联合化疗疗效。方法 收治３种主要病理类型的子宫肉瘤１７４例，回顾分析了５１例手术后辅助化疗以及３８例复发肿瘤共接受９８个疗程化疗的病例。术后辅助化疗方案分为４组：单药组、ＶＡＣ组（长春新碱、更生霉素、环磷酰胺）、ＶＡＤ组（长春新碱、阿霉素或表阿霉素、氮烯咪胺）及其他方案组。复发肿瘤化疗采用ＶＡＤ、ＰＡ／ＰＡＣ（顺铂、阿霉素或中霉素／顺铂、阿霉素或表阿霉素、环磷酰胺）

Combination chemotherapy of uterine sarcomas]

OBJECTIVE: To study the results of combination chemotherapy of uterine sarcoma after operation and recurrent tumor. METHODS: One hundred seventy-four cases of three major pathological subtypes of uterine sarcomas were treated in the Cancer Hospital from 1960 to 1996. Clinical data were analyzed of 51 cases of uterine sarcomas treated with postoperative adjuvant chemotherapy and 38 cases with recurrent tumors received 98 courses of chemotherapy. They were divided into 4 groups according to the adjuvant chemotherapy regimen: single drug, VAC, VAD, and other regimens. Chemotherapy regimens for recurrent tumors were VAD, PA/PAC, and other combination regimens including etoposide, ifosfamide, cisplatin, adriamycin. RESULTS: The 5-year survival rate of stage I-II uterine sarcoma patients was 54.9% receiving adjuvant chemotherapy. It was 72.7% in VAD group which was significantly higher than that in other regimen groups. The survival rate was related to the number of chemotherapy course. The chemo-sensitivity of various pathological types of recurrent uterine sarcomas was not different. CONCLUSION: The 5-year survival rate does not improve in patients with stage I-II uterine sarcomas given postoperative chemotherapy. VAD is among the best regimens and at least 3 courses should be performed. The results of new treatment regimens such as EPA, IA, etc., must await further clinical observation.