早期高危子宫内膜癌“夹心模式”序贯放化疗的疗效分析

目的评估“化疗-放疗-化疗”的“夹心模式”序贯放化疗在早期高危子宫内膜癌患者中疗效及可行性。方法回顾性分析2004年1月至2015年12月于北京大学人民医院行分期手术,分期(FIGO 2009)Ⅰ~Ⅱ期,且术后行“夹心疗法”的内膜癌患者,分析其临床病理特征,复发、生存及副反应。结果40例纳入研究,平均年龄(57±7)岁;随访51~182个月,仅1例术后66个月发生远处复发,其余均无瘤生存;5年总生存率及无疾病生存率均100%;无疾病生存期(178.7±3.3)m(95%CI:172.3~185.1);16例出现化疗副反应,仅1例发生Ⅲ度骨髓抑制;8例出现放疗副反应,其中1例发生左侧输尿管狭窄,其余为Ⅰ~Ⅱ度副反应。结论“夹心疗法”应用于早期高危内膜癌具有较好疗效,副反应可耐受。因病例数有限,有待积累病例,进一步总结。

Analysis of sequential adjuvant radiotherapy and chemotherapy in“sandwich regime”for high-risk early stage endometrial cancer

Objective To evaluate the efficacy and feasibility of postoperative sequential chemotherapy and radiation,which was conducted in a"sandwich regime"of“chemotherapy-radiation-chemotherapy”for the treatment of high-risk early stage endometrial cancer patients.Methods A retrospective analysis was conducted of the endometrial cancer patients who underwent staging operation in Peking University People’s Hospital from January 2004 to December 2015.The patients of stageⅠandⅡ(FIGO 2009)who received postoperative radiochemotherapy in a"sandwich regime"were included in the study.The clinical pathological characteristics,recurrence and survival outcomes of patients and side effects of radiochemotherapy were analyzed.Results 40 patients were included in the study.The average age was(57±7)years old.With follow-up of 51~182 months,only one patient had distant recurrence at 66 months postoperatively.The other patients all survived with no tumor.The 5-year overall survival rate and disease-free survival rate were both 100%.The disease-free survival period was(178.7±3.3)m(95%CI 172.3~185.1).16 patients had side effects of chemotherapy.Only 1 patient suffered gradeⅢmyelosuppression.8 patients had side effects of radiotherapy.1 patient had left ureteral stenosis and the rest patients had gradeⅠ~Ⅱside effects.Conclusion The radiochemotherapy delivered in“sandwich regime”for high-risk early stage endometrial cancer improved the 5-year disease-free survival and overall survival with tolerable adverse effect.It needs further comfirmation due to the limited number of cases.