子宫内膜腺癌不同治疗方法疗效的比较
Retrospective analysis of endometrial neoplasms treated by different therapeutic modalities
摘要目的 比较不同治疗方法治疗子宫内膜腺癌的疗效。方法 386例患者分别给予以下3种不同的治疗方法,(1)单纯手术(手术组)145例;(2)手术+放射治疗(放疗,手术+放疗组)161例;(3)单纯放疗(放疗组)80例。治疗后随访均在5年以上,观察各组的5年生存率。结果 手术病理分期(放疗组为临床分期)Ⅰ期、Ⅱ期及Ⅲ~Ⅳ期的5年生存率,手术组分别为78.9%(56/71)、61.0%(25/41)及18.2%(6/33);手术+放疗组分别为75.0%(33/44)、59.5%(44/74)及48.8%(21/43);放疗组分别为34.8%(8/23)、18.8%(3/16)及0.0%(0/41)。Ⅰ期及Ⅱ期患者的5年生存率,手术组与手术+放疗组比较,差异无显著性(P>0.05),而Ⅲ~Ⅳ期手术+放疗组明显高于手术组(P<0.001);放疗组无论分期如何,其5年生存率均显著低于手术组和手术+放疗组(P<0.001)。结论 子宫内膜腺癌应尽量争取以手术为主的治疗,单纯放疗仅适于有手术禁忌证的患者。
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abstractsObjective To compare the therapeutic effects of different remedis in patients with endometrial carcinoma. Methods Total of 386 patients with metracarcinoma underwent 3 different treatments: (1) operation only 145 cases; (2) operation and complemental radiotherapy 161 cases; (3) radiotherapy only 80 cases. Then they were followed up for 5 years and more. Results The 5-year survival rates of operation group were 78.9% (56/71), 61.0% (25/41) and 18.2% (6/33) in stage Ⅰ, stage Ⅱ, and stage Ⅲ~Ⅳ respectively, for operation and complemental radiotherapy,they were 75.0% (33/44), 59.5% (44/74) and 48.8% (21/43), for radiotherapy, 34.8% (8/23), 18.8% (3/16) and 0.0% (0/41). There was no difference between operation group and operation plus radiotherapy in patients with stage Ⅰ and stage Ⅱ (P>0.05). However the 5-year survival rates were significantly higher in operation plus complemental radiotherappy group and those only received operation in stage Ⅲ stage Ⅳ patients (P<0.001). And no matter in what stages, the therapeutic effect was worse in radiotherapy group than other two groups (P<0.001). Conclusion The remedis with operation as main measure are the best choice for metracarcinoma, radiotherapy merely is fit with those who can not be operated on.
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