摘要
目的探讨化疗在复发子宫内膜癌患者治疗中的作用。方法对20例复发子宫内膜癌患者进行回顾性研究。主要分析内容为肿瘤的复发情况、复发后的治疗情况及化疗对预后的影响。结果复发患者20例,占同期内膜癌患者总数的11.0%。患者平均于初治后(17±10)个月复发。20例复发患者中11例(55.0%)接受化疗,平均(6±4)个疗程。再次治疗后,20例患者的平均随访时间为(17±16)个月,其中1例(5.0%)无瘤生存,4例(20.0%)带瘤生存,15例(75.0%)因癌死亡。单因素分析提示,是否接受化疗及化疗疗程数与患者预后明显相关(均P<0.05),是否放疗也与预后有关(P<0.05),而肿瘤病理类型、初次手术分期、肿瘤细胞分化程度、年龄和复发时间、是否手术、不同化疗方案、化疗给药途径及是否接受内分泌治疗与患者预后无关。多因素分析提示,复发后化疗对患者预后有显著影响(β=-1.349,OR=0.259,P<0.05)。结论综合治疗可以提高复发子宫内膜癌患者的生存率,化疗在其中起主导性作用,对患者预后有重要影响。
Objective To explore the effects of chemotherapy in recurrent endometrial carcinoma. Methods A retrospective study was carried out on the clinical data of 20 cases of recurrent endometrial carcinoma hospitalized from May. 1992 to Jura 2002. Results The recurrence rate of these 20 cases was 11.0%. The recurrence occurred （17 ± 10） months after the first therapy. Eleven of the 20 patients （55.0%） had accepted chemotherapy with （6 ±4） courses and were followed up for （ 17 ± 16） months after the second therapy. Fifteen cases （75.0%） died of cancer, 4 cases survived with tumor, and only 1 case （5.0%） was tumor-free. Univariate model revealed that chemotherapy and number of chemotherapy course were related with the prognosis （P = 0. 0146, P = 0. 0353 ）. Radiotherapy o affected the prognosis too （P = 0.0414）. But pathologic subtype, stage, tumor cell differentiation, age, recurrent time, surgery, chemotherapy scheme, drug infusion way , and endocrine therapy had no relation with the prognosis （ P =0. 5517, 0.5763, 0. 1879, 0. 880, 0. 453, 0. 0672, 0. 0795, 0. 5956, and 0. 2035）. Multivariate model revealed that chemotherapy had influence on the prognosis （β = - 1. 349, OR = 0. 259, P = 0. 026 ）. Conclusion Combined treatment raises the survival of the recurrent endometrial carcinoma patients, in which chemotherapy plays a leading role and influences the prognosis remarkably.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第13期896-900,共5页
National Medical Journal of China
基金
"985"工程基金资助项目(985-2-015-24)
关键词
子宫内膜肿瘤
复发
预后
药物疗法
Endometrial Neoplasms
Recurrence
Prognosis
Drug therapy
