摘要
子宫内膜癌(endometrial cancer,EC)是女性生殖道常见恶性肿瘤,近年来发病率呈上升趋势。大约80%~90%的EC患者为早期,早期EC的治疗方式以先手术为主,术后根据危险因素行辅助放化疗,5年生存率超过80%。然而对于晚期EC患者,5年生存率仅为15%。晚期患者治疗手段有限,多采用手术、化疗、放疗等综合治疗手段。与晚期卵巢癌类似,晚期EC理想减瘤术与预后相关,临床Ⅲ/Ⅳ期的EC患者,如果可以接受手术,应行最大限度的减瘤术,尽可能达到无肉眼残留病灶。但是,对于有全身多发转移和有手术禁忌证的患者,首选新辅助化疗(neoadjuvant chemotherapy,NACT)后再行手术,目的是提高肿瘤的切除率和减少手术并发症。晚期EC NACT包括化疗药物、免疫治疗、抗血管生成治疗、靶向治疗和激素治疗。文章对NACT在晚期EC治疗中的相关研究进行综述,以期了解NACT在晚期EC的应用现状,为临床诊疗提供参考。
Endometrial cancer is a common malignant tumor of female malignant tumors and its incidence is increasing in recent years.About 80%-90%of EC patients are in the early stage.In the early stage of EC,surgery is the main treatment,and adjuvant radiotherapy or chemotherapy is performed according to the risk factors after surgery.The 5-year survival rate is more than 80%.However,the 5-year survival rate is only 15%for patients with advanced EC.For advanced patients with limited methods of treatment,surgery,chemotherapy,radiotherapy and other comprehensive treatment methods are used.Similar to advanced ovarian cancer,maximum cytoreductive surgery for advanced EC is associated with prognosis.Patients with stageⅢ/ⅣEC,if surgery is available,should undergo maximum tumor reduction to achieve no residual lesions as far as possible.However,for patients with systemic multiple metastases and contraindications,neoadjuvant chemotherapy(NACT)is the preferred option followed by surgery,which is aimed at improving tumor resection rate and reducing surgical complications.NACT for advanced endometrial cancer include chemotherapy agents,immunotherapy,antiangiogenic therapy,targeted therapy,and hormonal therapy.This article reviews the relevant studies of NACT in the treatment of advanced endometrial cancer,in order to understand the application status of NACT in advanced EC and provide reference for clinical diagnosis and treatment.
作者
赵冰冰
李力
ZHAO Bing-bing;LI Li(Department of Gynecologic Oncology,Affiliated Tumor Hospital of Guangxi Medical University,Key Laboratory of Early Prevention and Treatment for Guangxi Regional High Frequency Tumor(Ministry of Education),Nanning 530021,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2023年第7期693-698,共6页
Chinese Journal of Practical Gynecology and Obstetrics
基金
广西自然科学基金(2022JJA140926)
广西区域性高发肿瘤早期防治研究教育部重点实验室自主课题(ZZ202239)。
关键词
子宫内膜癌
晚期子宫内膜癌
新辅助化疗
endometrial cancer
advanced endometrial cancer
neoadjuvant chemotherapy
