COMBINED TREATMENT OF PATIENTS WITH ENDOMETRIAL CANCER I-II (Т1-2N0M0) TAKING INTO ACCOUNT THE LEVEL OF EXPRESSION OF MOLECULAR BIOLOGICAL TUMOR MARKERS

Abstract

One of the most relevant and promising areas in the world of oncogynecology, enabling deeper understanding of the etiology and pathogenesis of malignant growth, to study the processes occurring in women, is the study of molecular biological markers, characterizing apoptosis, cell proliferation and angiogenesis. To increase the effectiveness of combined treatment of the patients with endometrial cancer I−II (Т1−2N0M0) stages and prevent the occurrence of local recurrences as well as distant metastases on the basis of investigating the molecular biological features of tumor and their prognostic value, a study based on clinical observations of 125 women was performed. Their treatment included surgery and a postoperative course of remote radiation therapy. The strategy of adjuvant therapy was designed according to the definition of the group of increased risk of cancer recurrence in the patients with negative receptor status (ER, PR) based on the degree of differentiation of endometrial adenocarcinoma (G), depth of tumor invasion into the myometrium and its location in the cavity as well as the level of expression of molecular biological markers (VEGF, Bcl−2, Ki−67). To select the tactics of further treatment, each of the indices was evaluated in points on a scale. Next, the intervals of the total value of S points were set, depending on which the program of combined adjuvant therapy was chosen: up to 6 points the contact radiation therapy was performed, 7−12 points − there was applied a remote in the postoperative period; 13 points − after remote and contact radiation, six more cycles of chemotherapy were added. Analysis of the research results showed that the developed method of combined treatment of patients with endometrial cancer I−II (Т1−2N0M0) stages allows the personalization of the protocol of adjuvant therapy and recurrence prevention. Key words: endometrial cancer, molecular biological markers, treatment results, adjuvant therapy.