Adjuvant treatment for endometrial cancer: Literature review and recommendations by the Comite de l'evolution des pratiques en oncologie (CEPO)

被引：17

作者：

Morneau, Melanie ^{[7
,17
]}

Foster, William ^{[5
]}

Lalancette, Marc ^{[5
]}

Thu Van Nguyen-Huynh ^{[18
]}

Renaud, Marie-Claude ^{[5
]}

Samouelian, Vanessa ^{[18
]}

Letarte, Nathalie ^{[12
,13
,18
]}

Almanric, Karine ^{[1
]}

Boily, Gino ^{[2
]}

Bouchard, Philippe ^{[3
]}

Boulanger, Jim ^{[2
]}

Cournoyer, Ghislain ^{[4
]}

Couture, Felix ^{[5
]}

Gervais, Normand ^{[6
]}

Goulet, Stephanie ^{[7
]}

Guay, Marie-Pascale ^{[8
]}

Kavanagh, Melanie ^{[7
]}

Lemieux, Julie ^{[9
]}

Lesperance, Bernard ^{[10
,11
]}

Letarte, Nathalie ^{[12
,13
,18
]}

Morneau, Melanie ^{[7
,17
]}

Ouellet, Jean-Francois ^{[5
]}

Pineau, Gilles ^{[2
]}

Rajan, Raghu ^{[14
]}

Roy, Isabelle ^{[1
]}

Samson, Benoit ^{[15
]}

Sideris, Lucas ^{[3
]}

Vincent, Francois ^{[16
]}

机构：

[1] Hop Cite de la Sante, CSSS Laval, Laval, PQ, Canada

[2] Inst Natl Excellence Sante & Serv Sociaux, Quebec City, PQ, Canada

[3] Hop Maison Neuve Rosemont, Montreal, PQ H1T 2M4, Canada

[4] Hop Reg St Jerome, CSSS St Jerome, St Jerome, PQ, Canada

[5] CHU Quebec, Hotel Dieu Quebec, Quebec City, PQ, Canada

[6] Ctr Hosp Reg Grand Portage, CSSS Riviere du Loup, Riviere Du Loup, PQ, Canada

[7] Direct Quebecoise Cancerol MSSS, Quebec City, PQ, Canada

[8] McGill Univ, Jewish Gen Hosp, Montreal, PQ H3T 1E2, Canada

[9] CHU Quebec, Hop St Sacrement, Quebec City, PQ, Canada

[10] Hop Sacre Coeur, Montreal, PQ H4J 1C5, Canada

[11] Grp Etud Oncol Quebec, Montreal, PQ, Canada

[12] Hop Notre Dame CHUM, Montreal, PQ H2L 4M1, Canada

[13] Programme Gest Therapeut Medicaments, Montreal, PQ, Canada

[14] Montreal Gen Hosp MUHC, Montreal, PQ, Canada

[15] Hop Charles LeMoyne, Greenfield Pk, PQ, Canada

[16] CSSS Trois Rivieres, Pavillon St Marie, Trois Rivieres, PQ, Canada

[17] Minist Sante & Serv Sociaux Quebec MSSS, Direct Quebecoise Cancerol, Quebec City, PQ, Canada

[18] Ctr Hosp Univ Montreal, Hop Notre Dame, Montreal, PQ, Canada

来源：

GYNECOLOGIC ONCOLOGY | 2013年 / 131卷 / 01期

关键词：

Cancer; Endometrium; Chemotherapy; Radiotherapy; Adjuvant; PHASE-III TRIAL; QUALITY-OF-LIFE; WHOLE-ABDOMINAL-IRRADIATION; OPERATIVE RADIATION-THERAPY; EXTERNAL-BEAM RADIOTHERAPY; STAGE-I; PELVIC RADIOTHERAPY; POSTOPERATIVE RADIOTHERAPY; INTERMEDIATE-RISK; VAGINAL BRACHYTHERAPY;

D O I：

10.1016/j.ygyno.2013.07.084

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective. Despite the very good prognosis of endometrial cancer, a number of patients with localized disease relapse following surgery. Therefore, various adjuvant therapeutic approaches have been studied. The objective of this review is to evaluate the efficacy and safety of neoadjuvant and adjuvant therapies in patients with resectable endometrial cancer and to develop evidence-based recommendations. Methods. A review of the scientific literature published between January 1990 and June 2012 was performed. The search was limited to published phase III clinical trials and meta-analyses evaluating the efficacy of neoadjuvant or adjuvant therapies in patients with endometrial carcinoma or carcinosarcoma. A total of 23 studies and five meta-analyses were identified. Results. The selected literature showed that in patients with a low risk of recurrence, post-surgical observation is safe and recommended in most cases. There are several therapeutic modalities available for treatment of endometrial cancers with higher risk of recurrence, including vaginal brachytherapy, external beam radiotherapy, chemotherapy, or a combination of these. Conclusions. Considering the evidence available to date, the CEPO recommends the following: 1) post-surgical observation for most patients with a low recurrence risk; 2) adjuvant vaginal brachytherapy for patients with an intermediate recurrence risk; 3) adjuvant pelvic radiotherapy with or without vaginal brachytherapy for patients with a high recurrence risk; addition of adjuvant chemotherapy may be considered as an option for selected patients (excellent functional status, no significant co-morbidities, poor prognostic factors); 4) adjuvant chemotherapy and pelvic radiotherapy with or without brachytherapy and para-aortic irradiation for patients with advanced disease; 5) hormonal therapy is not recommended in the adjuvant setting. (C) 2013 Elsevier Inc. All rights reserved.

引用

页码：231 / 240

页数：10

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