现在还是以后? 新辅助治疗在晚期子宫内膜癌中的作用:系统性审查
Carlo Ronsini1, Irene Iavarone1, Alessandro Carotenuto1
1Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Healthcare (Basel, Switzerland)
|December 17, 2024
概括
与前期手术相比,新辅助化疗和放射疗法在晚期子宫内膜癌中显示出有希望的生存结果. 需要更多的数据,但目前的发现表明新辅助治疗策略可能有好处.
科学领域:
- 妇科瘤学 妇科瘤学
- 医学瘤学 医学瘤学
- 辐射瘤学 辐射瘤学
背景情况:
- 子宫内膜癌 (EC) 是全球最常见的妇科恶性瘤.
- 手术是早期EC的主要治疗方法; 化学疗法 (CT) 卡博普拉丁和帕克利塔塞尔是晚期疾病的标准.
- 先进的EC治疗通常涉及转移或复发病例的化疗.
研究的目的:
- 系统地审查和比较新辅助治疗 (CT和/或RT) 与先发性子宫内膜癌前期手术的生存结果.
- 评估新辅助疗法对无病生存期 (DFS),总生存期 (OS) 和复发率 (RR) 的影响.
主要方法:
- 在遵守PRISMA指南的基础上进行系统审查.
- 使用关键词进行文献搜索: "子宫内膜瘤", "乳腺切除术", "放射治疗" 和 "化疗".
- 使用纽卡斯尔-太华尺度 (NOS) 进行质量评估;包括的研究比较了前期手术与新辅助CT ± EBRT或CT ± BT.
主要成果:
- 五年DFS:21.3% (前部手术) 与42-73% (新辅助CT).
- 五年操作系统:6.2-49.7% (前部手术) 与15.5-100% (新辅助方案) 相比.
- 五年RR:没有报告前期手术;新辅助治疗的27-64.7%.
结论:
- 数据有限使得新辅助疗法和先发性手术之间的确切比较难以进行.
- 目前的证据表明,新辅助治疗组在生存和复发方面具有更有利的结果.
- 需要进一步的研究,以确定晚期子宫内膜癌的最佳新辅助治疗方案.
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