Hormonal Therapy for Women With Stage IA Endometrial Cancer of All Grades
Hormonal Therapy for Women With Stage IA Endometrial Cancer of All Grades
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DOI：
10.1097/aog.0b013e3182964ce3
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发表时间：
2013-07-01
影响因子：
7.2
通讯作者：
Nam, Joo-Hyun
中科院分区：
文献类型：
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作者：
Park, Jeong-Yeol;Kim, Dae-Yeon;Nam, Joo-Hyun
目的：评价孕激素对IA期、分化程度为1级伴浅肌层侵犯或IA级分化为2~3级分化伴或不伴浅层肌层侵犯的育龄妇女口服孕激素治疗后的肿瘤和妊娠结局。方法：回顾48例符合纳入标准的子宫内膜样腺癌患者，年龄40岁及以下，口服孕激素保守治疗。结果：中位年龄为30岁(23-40岁)。14例(29.2%)每日口服甲地孕酮(中位剂量160 mg/d，40~240 mg/d)，34例(70.8%)每日口服甲孕酮(中位剂量500 mg/d，范围80~1000 mg/d)。中位疗程10个月(3~20个月)，完全缓解37例(77.1%)。IA期无肌层侵犯(17例)、IA期1级浅表肌层侵犯(23例)、IA期2~3级浅表肌层侵犯(8例)的完全缓解率分别为76.5%、73.9%和87.5%(P=.731)。37例获得完全缓解的患者，中位随访时间为48个月(7~136个月)，复发率分别为23.1%、47.1%和71.4%(P=0.104)。没有人经历疾病进展或死于这种疾病。9例患者产下10例健康新生儿。结论：孕激素治疗IA期、分化2~3级无肌层侵犯和IA 1级分化伴浅表肌层侵犯的患者有较好的疗效。
OBJECTIVE: To estimate the oncologic and pregnancy outcomes after oral progestin treatment of women of reproductive age with stage IA endometrial adenocarcinoma with stage IA, grade 1 differentiation with superficial myometrial invasion or stage IA, grade 2-3 differentiation with or without superficial myometrial invasion.METHODS: Medical records of 48 women (age 40 years or younger) with endometrioid adenocarcinoma of the uterus who met inclusion criteria and were treated conservatively with oral progestin were reviewed. Follow-up was performed primarily with imaging techniques followed by endometrial biopsy when indicated.RESULTS: The median age was 30 years (range, 23-40 years). Fourteen patients (29.2%) received daily oral megestrol acetate (median dose 160 mg per day, range 40-240 mg per day) and 34 (70.8%) received daily oral medroxyprogesterone acetate (median dose 500 mg per day, range 80-1,000 mg per day). Complete responses were observed for 37 patients (77.1%) after the median treatment duration of 10 months (range 3-20 months). Complete response rates were 76.5%, 73.9%, and 87.5% for patients with stage IA, grade 2-3 without myometrial invasion (n=17), for patients with stage IA, grade 1 with superficial myometrial invasion (n=23), and for patients with stage IA, grade 2-3 with superficial myometrial invasion (n=8), respectively (P=.731). Recurrence rates for 37 patients who achieved complete response after a median follow-up time of 48 months (range 7-136 months) were 23.1%, 47.1%, and 71.4%, respectively (P=.104). None experienced disease progression or died of the disease. Nine patients gave birth to 10 healthy newborns.CONCLUSION: Progestin treatment appears to be reasonably effective for patients with stage IA, grade 2-3 differentiation without myometrial invasion and patients with stage IA grade 1 differentiation with superficial myometrial invasion.