摘要
目的分析宫颈癌放疗后子宫体恶性肿瘤的临床特点。方法回顾性分析47例宫颈癌放疗后子宫体恶性肿瘤的临床资料。结果诊断宫体恶性肿瘤的中位年龄为62岁，放疗后至确诊发生肿瘤的中位时间为14年。47例中，子宫内膜癌30例，子宫中胚叶混合瘤17例。30例子宫内膜癌的FIGO分期为IB期1例，IC期2例，Ⅱ期6例，ⅢA期4例，ⅢB期2例，ⅢC期11例，Ⅵ期4例，Ⅱ期以上者占90%；病理高分化2例，中分化9例，低分化14例，不能分级者2例，浆液性乳头状腺癌3例；7例疗后复发，中位复发时间为24个月；中位生存时间为26个月，总3、5年生存率分别为60%、38%。17例子宫中胚叶混合瘤，中位生存10个月，6例疗后复发，中位复发时间9个月；复发者中位生存6个月，总3、5年生存率分别为12%、0。结论宫颈癌放疗后发生的肿瘤以内膜腺癌多见，内膜腺癌中具有高危因素者比例大，预后差；放疗后发生子宫肉瘤中以中胚叶混合瘤最常见，预后差。
Objective To analysis the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods The clinical data of 47 patients of uterine neoplasm developed following radiotherapy for uterine cervical carcinoma were retrospectively reviewed. Results The median age on diagnosis of uterine neoplasms was 62 years （ range 38-77 ）, and the median latency from the initial therapy to the development of uterine neoplasm was 14 years （ range 5-35 ）. Thirty of 47 patients had endometrial carcinoma, of which 3 were uterine papillary serous carcinoma（UPSC）. Seventeen of 47 patients had uterine sarcoma, all of which were careinosareoma. The distribution by stage, grade, and histology of 30 patients with endometrial carcinoma was ： stage Ib, 1 patient; stage Ic, 2 patients; stage Ⅱ, 6; stage Ⅲa, 4; stage Ⅲb, 2; stage Ⅲc, 11; stage Ⅳ, 4; grade 1,2 patients; grade 2, 9; grade 3（ include 3 UPSC patients）, 17; unknown grade, 2; endometriod, 27; UPSC, 3. Seven of 30 patients with endometrial carcinoma deleloped recurrence, at median time of 24 months. Their median survival time was 26 m. The overall 3- and 5-year survival rate was 60% and 38%, respectively. Of the 17 patients with uterine sarcoma, the median survival was 10 months. Six patients developed recurrence, at a median time of 9 months, and their median survival was 6 months . The overall 3- and 5-year survival rate was 12% and 0, respectively. Conclusions The main uterine neoplasm developed after radiotherapy for uterine cervical carcinoma is endometrial carcinoma, of which there is a preponderance of high-risk histological subtype and poor prognosis. Most of the uterine sarcoma which occur following radiation therapy for uterine cervical carcinoma is carcinosarcoma and its prognosis is very poor.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2007年第2期121-124,共4页
Chinese Journal of Radiation Oncology
