吉林大学学报(医学版) ›› 2025, Vol. 51 ›› Issue (6): 1747-1754.doi: 10.13481/j.1671-587X.20250632
收稿日期:2025-03-12
接受日期:2025-05-15
出版日期:2025-11-28
发布日期:2025-12-15
通讯作者:
何明远,程光惠
E-mail:hemingyuan@jlu.edu.cn;chenggh@jlu.edu.cn
作者简介:刘 腾(2000-),女,山东省泰安市人,在读硕士研究生,主要从事妇科肿瘤放射治疗方面的研究。
基金资助:
Teng LIU,Ning ZHANG,Mingyuan HE(
),Guanghui CHENG(
)
Received:2025-03-12
Accepted:2025-05-15
Online:2025-11-28
Published:2025-12-15
Contact:
Mingyuan HE,Guanghui CHENG
E-mail:hemingyuan@jlu.edu.cn;chenggh@jlu.edu.cn
摘要:
子宫内膜癌是女性生殖系统常见的恶性肿瘤之一,在我国发病率仅次于宫颈癌,严重威胁女性生命健康,且发病呈年轻化趋势。目前,子宫内膜癌的治疗方式主要为手术治疗,部分术后患者及术后复发患者需行辅助放射治疗。盆腔外照射(EBRT)及阴道近距离放射治疗(VBT)为术后放射治疗的2种方式,需根据个体情况及指南推荐,为患者选择合适的术后放射治疗方式。多数患者通过手术及术后辅助放射治疗,能够取得理想的治疗效果。然而,子宫内膜癌患者术后放射治疗的具体适应证及术后复发患者的放射治疗原则较为复杂,不同指南推荐的术后患者放射治疗方式也略有不同。现对近年来子宫内膜癌患者的治疗原则、术后和术后复发放射治疗适应证及放射治疗方式进行综述,旨在为子宫内膜癌患者的放射治疗提供参考。
中图分类号:
刘腾,张宁,何明远,程光惠. 子宫内膜癌治疗原则及其术后和术后复发放射治疗的研究进展[J]. 吉林大学学报(医学版), 2025, 51(6): 1747-1754.
Teng LIU,Ning ZHANG,Mingyuan HE,Guanghui CHENG. Research progress in treatment principles for endometrial cancer and its postoperative and postoperative recurrent radiotherapy[J]. Journal of Jilin University(Medicine Edition), 2025, 51(6): 1747-1754.
表1
常见指南治疗原则总结"
| Guideline | Low-risk | Intermediate-risk | High-intermediate risk | High-risk |
|---|---|---|---|---|
FIGO[ | Adjuvant radiotherapy is not recommended. | - | VBT alone demonstrated superior efficacy compared to EBRT. | EBRT is recommended for these patients. In Stage Ⅲ disease, the addition of chemotherapy to EBRT improves recurrence-free survival. |
ESGO-ESTRO-ESP[ | Adjuvant radiotherapy is not recommended. | VBT demonstrated efficacy in reducing vaginal recurrence rates. For patients under the age of 60, VBT may not be considered. | For patients with pathological nodal staging of pN0: VBT reduces the risk of vaginal recurrence. EBRT may be considered in cases with extensive LVSI or Stage Ⅱ disease. Adjuvant chemotherapy can be considered, particularly for patients with G3 histology and/or extensive LVSI. Omission of adjuvant therapy is an option, provided that close surveillance is maintained to ensure early detection and treatment of recurrence. For patients without nodal staging (cN0/pNx): EBRT is recommended for those with extensive LVSI and/or Stage Ⅱ disease. The addition of adjuvant chemotherapy should be considered, particularly for patients with G3 histology and/or extensive LVSI. For patients with G3 histology without LVSI or Stage Ⅱ G1 endometrioid carcinoma,VBT alone may be considered. | Concurrent chemoradiotherapy or sequential chemoradiotherapy is advised. Chemotherapy alone may also be considered as an alternative treatment strategy. |
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