子宫平滑肌肉瘤系统治疗

子宫平滑肌肉瘤（uterine leiomyosarcoma，uLMS）是一种罕见的子宫间质肿瘤，其发病率低，是一种高度恶性肿瘤，即使是早期治疗，仍具有较高的复发率和转移风险。该疾病的术前诊断较困难，不如宫颈癌和子宫内膜癌有很好的诊断手段，术中存在治疗不足或治疗方式不恰当的情况，因此该疾病的预后较差。目前手术治疗仍是该疾病的主要治疗方案，术后的辅助治疗方案有很多，如辅助放疗、辅助化疗、靶向治疗、联合治疗或者进行随访观察，由于发病率低、研究的数量少以及疾病进展较快，迄今仍没有一个统一的标准治疗方案，且辅助治疗的效果不理想，临床获益较少。综述uLMS系统治疗的相关知识，尤其是在辅助治疗、转移病灶中以及意外中发现该疾病的治疗，为临床治疗提供参考性意见。

Systemic Treatment of Uterine Leiomyosarcoma

Uterine leiomyosarcoma (uLMS) is a rare uterine interstitial tumor with a low incidence and a high malignant tumor. Even with early treatment, uLMS still has a highly by recurrence rate and metastasis risk. The preoperative diagnosis of the disease is difficult, not like cervical cancer, endometrial cancer has good diagnostic tools, intraoperative existence of inappropriate treatment or inadequate treatment way, so the disease prognosis is poor. Surgical treatment is still the main treatment of the disease, postoperative adjuvant treatment has a lot of scheme, for example adjuant radiation therapy, chemotherapy, targeted therapy, combination treatment or follow-up observation. Due to low morbidity, low number of studies and rapid disease progression, there is still no unified standard solution, and the efficacy of adjuvant therapy is not ideal, with few clinical benefits. This paper discusses the knowledge of systematic treatment of uLMS, especially in the treatment of adjuvant therapy, metastatic lesion and accidental discovery of this disease, providing reference for clinical treatment.