子宫内膜癌治疗方法的评价

目的评价子宫内膜癌不同治疗方法的疗效。方法对1960 2001年间北京妇产医院收治的867例子宫内膜癌的临床及病理资料进行回顾性分析。按治疗方法归纳为3组:术前腔内半量放疗+手术组(HR+S组)、手术组(S组)、单纯放疗组(R组)。结果临床Ⅰ期(570例)HR+S组、S组、R组5年生存率分别为93.7%、90.7%和57.8%;临床Ⅱ期(134例)3组的5年生存率分别为88.3%、64.3%和25.1%。Ⅰ期与Ⅱ期5年生存率HR+S组与S组之间比较,差异均无统计学意义(P>0.05),与R组相比差异均有统计学意义(P<0.01)。结论对于临床Ⅰ、Ⅱ期子宫内膜癌,综合治疗明显好于单纯放疗;术前腔内半量放疗再行全子宫双附件切除术与手术(筋膜外次广泛全子宫双附件切除),术后高危型均补充放疗,2种治疗方法疗效无差异。

The Assessment of Different Therapies for Endometrial Carcinoma

Objective To assess the different therapies for endometrial carcinoma retrospectively.Methods From 1960 to 2001,867 patients with endometrial carcinoma were treated in our hospital.Their clinical and pathological data were analyzed retrospectively.The patients were divided into three groups according to the different therapeutic methods: half dose preoperative radio-brachytherapy and surgery(HR+group S),surgery(group S),radiotherapy(group R).Results The 5 year survival ratesof HR+group S,group S and group R were 93.7%,90.7% and 57.8% respectively in clinical stageⅠ(570 cases),88.3%,64.3% and 25.1% respectively in clinical stageⅡ(134 cases).No significant differences between HR+group S and group S were observed in clinical stageⅠand Ⅱ cases respectively(P>0.05).Meanwhile,The 5 year survival rates of HR+group S,and group S were significantly higher than that of group R in clinical stageⅠand Ⅱ(P<0.01).Conclusion For patients with the endometrial carcinoma in clinical stageⅠand Ⅱ,combined treatment is better than radiotherapy;No significant differences between operation combined with half dose preoperative radio-brachytherapy and surgery.