化疗在复发子宫内膜癌治疗中的作用

目的探讨化疗在复发子宫内膜癌患者治疗中的作用。方法对20例复发子宫内膜癌患者进行回顾性研究。主要分析内容为肿瘤的复发情况、复发后的治疗情况及化疗对预后的影响。结果复发患者20例,占同期内膜癌患者总数的11.0%。患者平均于初治后(17±10)个月复发。20例复发患者中11例(55.0%)接受化疗,平均(6±4)个疗程。再次治疗后,20例患者的平均随访时间为(17±16)个月,其中1例(5.0%)无瘤生存,4例(20.0%)带瘤生存,15例(75.0%)因癌死亡。单因素分析提示,是否接受化疗及化疗疗程数与患者预后明显相关(均P<0.05),是否放疗也与预后有关(P<0.05),而肿瘤病理类型、初次手术分期、肿瘤细胞分化程度、年龄和复发时间、是否手术、不同化疗方案、化疗给药途径及是否接受内分泌治疗与患者预后无关。多因素分析提示,复发后化疗对患者预后有显著影响(β=-1.349,OR=0.259,P<0.05)。结论综合治疗可以提高复发子宫内膜癌患者的生存率,化疗在其中起主导性作用,对患者预后有重要影响。

Effects of chemotherapy in recurrent endometrial carcinoma

OBJECTIVE: To explore the effects of chemotherapy in recurrent endometrial carcinoma. METHODS: A retrospective study was carried out on the clinical data of 20 cases of recurrent endometrial carcinoma hospitalized from May. 1992 to Jun. 2002. RESULTS: The recurrence rate of these 20 cases was 11.0%. The recurrence occurred (17 +/- 10) months after the first therapy. Eleven of the 20 patients (55.0%) had accepted chemotherapy with (6 +/- 4) courses and were followed up for (17 +/- 16) months after the second therapy. Fifteen cases (75.0%) died of cancer, 4 cases survived with tumor, and only 1 case (5.0%) was tumor-free. Univariate model revealed that chemotherapy and number of chemotherapy course were related with the prognosis (P = 0.0146, P = 0.0353). Radiotherapy affected the prognosis too (P = 0.0414). But pathologic subtype, stage, tumor cell differentiation, age, recurrent time, surgery, chemotherapy scheme, drug infusion way , and endocrine therapy had no relation with the prognosis (P = 0.5517, 0.5763, 0.1879, 0.880, 0.453, 0.0672, 0.0795, 0.5956, and 0.2035). Multivariate model revealed that chemotherapy had influence on the prognosis (beta = -1.349, OR = 0.259, P = 0.026). CONCLUSION: Combined treatment raises the survival of the recurrent endometrial carcinoma patients, in which chemotherapy plays a leading role and influences the prognosis remarkably.