【摘要】 目的:探讨序贯放化疗对高危子宫内膜癌术后患者的临床价值。方法:回顾性分析124例术后高危子宫内膜癌患者临床病理及随访资料,其中60例应用紫杉醇+卡铂化疗2个周期后行体外照射+后装治疗,放疗结束后再次给予TC方案化疗2～3个周期(序贯放化疗组),其余64例接受常规辅助放疗(单纯放疗组),观察两组患者的毒副作用、复发率、无疾病进展生存期及生存率。结果:截至2012-04-30,序贯放化疗组中位随访时间为31个月(4～44个月),放疗组为32个月(5～46个月)。序贯放化疗组中位无进展生存期29个月(4～45个月),明显高于放疗组的21个月(5～43个月),差异有统计学意义,P=0.044。序贯放化疗组总体复发率(6.9%)显著低于单纯放疗组(14.2%),P=0.022。序贯放化疗组患者3年无进展生存率为93.1%,与常规放疗组(85.8%)比较,差异有统计学意义,P=0.032;但1年的无进展生存率及1、3年总体生存率及复发率两组间差异均无统计学意义,P>0.05。序贯放化疗组血液系统和周围神经毒性反应发生率明显高于单纯放疗组,但无Ⅳ级化疗毒副作用发生。结论:序贯放化疗治疗高危子宫内膜癌术后患者,可延缓复发、提高近期无进展生存率,且毒性反应可耐受,有临床推广价值。更多还原

【Abstract】 OBJECTIVE: To assess the tolerability and efficacy of sequential chemotherapy and radiotherapy for the treatment of high risk endometrial cancer.METHODS: Postoperative high risk endometrial cancer patients who received sequential chemotherapy and radiotherapy from November 2007 to December 2011 were involved in this retrospective study.Sixty high risk endometrial cancer patients underwent complete surgical staging followed by adjuvant therapy encompassing sequential chemotherapy,radiation therapy and consolidation chemotherapy.The other 64 patients received routine radiotherapy.RESULTS: The median follow-up and progression free survival in sequential chemoradiotherapy group were 31 months and 29 months,respectively.The median progression free survival in sequential chemoradiotherapy group(29 months) was significantly longer than that in radiotherapy group(21 months,P=0.044).Obviously lower recurrence group was observed in sequential chemoradiotherapy group than that in control(6.9% vs 14.2%,P=0.022) and the 3-year PFS was higher in sequential chemoradiotherapy group(93.1% vs 85.8%,P=0.032).Although higher incidence of neurotoxicity and hematologic toxicities were observed in sequential chemoradiotherapy group,there was no grade 4 toxicity occurred in both group(P>0.05).CONCLUSIONS: The preliminary results from our study suggest that sequential chemoradiotherapy is feasible to treat high risk endometrial cancer patients.Hematologic toxicity is well tolerated and nonhematologic toxicity is manageable.Further study of this novel regimen in a larger group of patient with extended followup is necessary.更多还原