中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2010年
8期
105-107
,共3页
子宫内膜肿瘤%药物疗法%肿瘤细胞灭减术
子宮內膜腫瘤%藥物療法%腫瘤細胞滅減術
자궁내막종류%약물요법%종류세포멸감술
Garcinoma of endometrium%Drug therapy%Cytoreducine
目的 目前晚期子宫内膜癌患者生存率低、生活质量差,治疗无定规方案.为探讨其治疗.方法 对我院7年来36例晚期子宫内膜癌患者临床资料进行回顾性分析.Ⅲ期16例,Ⅳ期20例.所有患者均给予以手术治疗为主的综合治疗,基本手术方式为广泛全子宫切除+双附件+大网膜、阑尾切除及盆、腹腔内转移病灶切除.结果 本组肉眼无残余病灶者10例,残余病灶＜2 cm者20例,残余病灶＞2 cm者6例,手术满意率为83.3%(30/36).随访至2008年12月,5年生存率仅为31.3%(5/16),3年生存率为54.2%(13/24),1年生存率为91.7%(33/36).生存率与患者病变侵及范围、有无腹水、手术后残留病灶大小以及术后化疗周期长短等密切相关.结论 初步研究结果提示,提倡最大限度切除病灶减少肿瘤负荷,在理想的肿瘤细胞减灭术的基础上给予多疗程的联合化疗,而放射治疗的临床作用尚需进一步探讨.表明肿瘤细胞减灭术在晚期子宫内膜癌治疗中有重要价值.
目的 目前晚期子宮內膜癌患者生存率低、生活質量差,治療無定規方案.為探討其治療.方法 對我院7年來36例晚期子宮內膜癌患者臨床資料進行迴顧性分析.Ⅲ期16例,Ⅳ期20例.所有患者均給予以手術治療為主的綜閤治療,基本手術方式為廣汎全子宮切除+雙附件+大網膜、闌尾切除及盆、腹腔內轉移病竈切除.結果 本組肉眼無殘餘病竈者10例,殘餘病竈＜2 cm者20例,殘餘病竈＞2 cm者6例,手術滿意率為83.3%(30/36).隨訪至2008年12月,5年生存率僅為31.3%(5/16),3年生存率為54.2%(13/24),1年生存率為91.7%(33/36).生存率與患者病變侵及範圍、有無腹水、手術後殘留病竈大小以及術後化療週期長短等密切相關.結論 初步研究結果提示,提倡最大限度切除病竈減少腫瘤負荷,在理想的腫瘤細胞減滅術的基礎上給予多療程的聯閤化療,而放射治療的臨床作用尚需進一步探討.錶明腫瘤細胞減滅術在晚期子宮內膜癌治療中有重要價值.
목적 목전만기자궁내막암환자생존솔저、생활질량차,치료무정규방안.위탐토기치료.방법 대아원7년래36례만기자궁내막암환자림상자료진행회고성분석.Ⅲ기16례,Ⅳ기20례.소유환자균급여이수술치료위주적종합치료,기본수술방식위엄범전자궁절제+쌍부건+대망막、란미절제급분、복강내전이병조절제.결과 본조육안무잔여병조자10례,잔여병조＜2 cm자20례,잔여병조＞2 cm자6례,수술만의솔위83.3%(30/36).수방지2008년12월,5년생존솔부위31.3%(5/16),3년생존솔위54.2%(13/24),1년생존솔위91.7%(33/36).생존솔여환자병변침급범위、유무복수、수술후잔류병조대소이급술후화료주기장단등밀절상관.결론 초보연구결과제시,제창최대한도절제병조감소종류부하,재이상적종류세포감멸술적기출상급여다료정적연합화료,이방사치료적림상작용상수진일보탐토.표명종류세포감멸술재만기자궁내막암치료중유중요개치.
Objective To observe the clinical value of cytoreductive surgery in advanced endometiral cacinoma. Methods A retrospective study was performed in 36 cases of advanced endometrial carcinoma who received cytoreductive surgery. All the patients including 16 cases of stage Ⅲ and 20 cases of stage Ⅰ were treated with combined therapy based on operation. The basic method included total hysterectomy, both adnexectomy,omentectomy, appendectomy and resection of metastatic lesion in abdominopelvic cavity. Results The content rate of operation was 83.3 (30/36) , including 10 cases of no unaided eyeresidual focus ,20 cases of residual focus smaller than 2 cm and 6 cases of residual fucus larger than2 cm. To December 2007 ,the survival rates of,5 year,3 year and 1 year were 31.3(5/16) ,54. 2-(13/24)and 91.7 ～ (33/36) ,respectively. Conclusion The survival rate intimately correlated with the extent of disease, ascitcs, size of residual focus, circles of chemotherapy after the operation. In conclusion, cytoreductive surgery bas an important value in advanced endometiral cacinoma. Multi-circle combined chemotherapy based on ideal cytoreductive surgery ix effective, while radiotherapy has no further therapeutic effect.
