晚期子宫内膜癌术后不可测量疾病的处理。

IF 4.7 2区 医学 Q2 ONCOLOGY
Current Treatment Options in Oncology Pub Date : 2025-09-01 Epub Date: 2025-08-29 DOI:10.1007/s11864-025-01345-1
Stephanie M Wang, Julia Dexter, Rebecca Wolsky, Carolyn Lefkowits
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引用次数: 0

摘要

观点声明:晚期完全切除的子宫内膜癌患者是一个异质群体,对于该患者群体的辅助治疗决策是复杂的。在考虑这组患者时,组织学亚型和分子分类等因素会影响辅助治疗的决策。选择包括全身化疗,有或没有免疫治疗或her2靶向治疗,放化疗和单独放疗。我们建议根据HER2状态、错配修复(MMR)熟练程度、疾病分期和组织学对晚期、不可测量的子宫内膜癌患者进行定制治疗。对于her2阳性病例,我们推荐卡铂、紫杉醇和曲妥珠单抗。对于her2阴性,mmr合格的疾病,3期患者,我们推荐有IIIB或IIIC期疾病和1级或2级子宫内膜样组织学或3级子宫内膜样组织学p53野生型,我们推荐卡铂和紫杉醇,并考虑盆腔放疗。对于IIIA期疾病或3级p53异常子宫内膜样或非子宫内膜样组织学的患者,我们推荐卡铂和紫杉醇。考虑对有淋巴血管间隙侵犯、宫颈间质受损伤或子宫下段受损伤等子宫危险因素的患者进行近距离放疗。对于Her2阴性的MMRp疾病的4期患者,我们推荐卡铂和紫杉醇,并可选择近距离治疗。对于her2阴性、mmr缺陷的疾病,推荐的方案包括卡铂、紫杉醇和免疫治疗,并考虑对具有上述子宫危险因素的患者进行近距离治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of Advanced Stage Endometrial Cancer With Non-Measurable Disease After Surgery.

Opinion statement: Patients with advanced stage completely resected endometrial cancer represent a heterogeneous group and decision-making regarding adjuvant treatment for this patient population is complex. When considering this cohort of patients, factors such as histologic subtype and molecular classification impact decision-making on adjuvant therapy. Options include systemic chemotherapy with or without immunotherapy or HER2-targeted therapy, chemoradiotherapy and radiation alone. We recommend tailoring treatment for patients with advanced-stage, non-measurable endometrial cancer based on HER2 status, mismatch repair (MMR) proficiency, disease stage and histology. For HER2-positive cases, we recommend carboplatin, paclitaxel, and trastuzumab. For HER2-negative, MMR-proficient disease, Stage 3 patients we recommend that have stage IIIB or IIIC disease AND grade 1 or 2 endometrioid histology OR grade 3 endometrioid histology p53 wild-type, we recommend carboplatin and paclitaxel, with consideration of the addition of pelvic radiationFor patients with stage IIIA disease OR grade 3 p53 aberrant endometrioid OR non-endometrioid histology, we recommend carboplatin and paclitaxel, with consideration of brachytherapy for patients with uterine risk factors such as lymphovascular space invasion, cervical stromal involvement, or lower uterine segment involvement. For Stage 4 patients with Her2 negative, MMRp disease, we recommend carboplatin and paclitaxel, with optional brachytherapy. For HER2-negative, MMR-deficient disease, the recommended regimen includes carboplatin, paclitaxel, and immunotherapy, with consideration of brachytherapy for patients with the uterine risk factors listed above.

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来源期刊
CiteScore
7.10
自引率
0.00%
发文量
113
审稿时长
>12 weeks
期刊介绍: This journal aims to review the most important, recently published treatment option advances in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to facilitate worldwide approaches to cancer treatment. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as endocrine tumors, lymphomas, neuro-oncology, and cancers of the breast, head and neck, lung, skin, gastrointestinal tract, and genitourinary region. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known oncologists, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.
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