[Therapy of advanced endometrial cancer]

Abstract

In recent years, the incidence of endometrial cancer has a tendency to increase gradually in our country. Its majority (stage I and II) is a case to be treated by hysterectomy alone. However, to patients with advanced inoperable cancer (stage III and more), a radiotherapy, which is not so sensitive to endometrial cancer, has been used. Since the progression of endometrial cancer is dependent on sex steroid hormones (estrogen and progesterone), anti-tumor effects of progestogen are expected to be effective to patients with estrogen receptor (ER) positive and progesterone receptor (PR) positive cancer or with well-differentiated adenocarcinoma (G1 type) histologically. The most widely used progestogens are medroxyprogesterone acetate (MPA) and megestrol acetate (MGA). Many investigators have reported that progestogen with high dosage shows a good response to advanced endometrial cancer. On the other hand, the monochemotherapy responsive to endometrial cancer is adriamycin (ADR), cyclophosphamide (CPA), 5-fluorouracil (5-FU) or cisplatin (CDDP). The drugs in polychemotherapy regimens are used to be combined basically the above anti-cancer agents. The polychemotherapy is more effective than monochemotherapy. The combined chemotherapy regimen (CPA, ADR and CDDP; CAP regimen) obtained a good clinical results to advanced endometrial cancer. Thus, in recent years, the combined hormonochemotherapy of high dose progestogen and polychemotherapy was recommended as the best therapy to advanced endometrial cancer, and reported a good results. In conclusion, the treatment of advanced endometrial cancer is based on the use of progestogen therapy and on polychemotherapy. The choice of treatment is made on the basis of patients' conditions and the biological characteristics of the endometrial carcinoma.