Clinical Study And Systematic Evaluation Of Postoperative Adjuvant Chemoradiotherapy For Patients With Early-stage High-risk Endometrial Cancer

Objective To analysis the impact of clinical and pathological prognostic factors for endometrial carcinoma,to make better proposal of therapy. Methods:Retrospective analysis465patients who came from Guangxi cancer hospital1989.1to2009.5of early stage endometrial carcinoma. Kaplan-meier survival curves,Log-rank test, Cox multivariate test regression were used to analysis clinical and pathological prognostic factors of endometrial carcinoma. Results5-year OS of patients in group are80%.Logistic regression analysis: FIGO stage,cervical infiltration, ascites cytology, histology type, histological grade, depthy of muscular infiltration, vessel infiltration are the prognostic factors, ER?PR of5-year OS (P<0.05).Age is not the prognostic factor. Cox model analysis:FIGO stage,cervical infiltration, histological grade, depthy of muscular infiltration are the high-risk prognostic factors of endometrial carcinoma (P<0.05).conclusion The prognostic factors should be concerd in therapy. FIGO stage,cervical infiltration, histological grade, depthy of muscular infiltration are the high-risk prognostic factors of early stage endometrial carcinoma witch must be used in prognostic therapy. objective To analysis the therapeutic effect of different remedies of radiation therapy and chemotherapy in patients with early stage high-risk endometrial carcinoma. Methods There were261high-risk patientsw:surgery group66, radiation therapy group70, chemotherapy group69, radiation therapy and chemotherapy group56. Chemotherapy group is devided in<4courses group24and>4courses group45. Radiation therapy and chemotherapy group is devided in postoperative chemotherapy radiotherapy group27and postoperative radiotherapy chemotherapy group29.5year OS?PFS is the result.Cox analysis Chemotherapy group and therapy and chemotherapy group.Results Surgery group?chemotherapy group?radiation therapy group?radiation therapy and chemotherapy group5year OS:76%?71.2?95.5%and87%.5year PFS is53%?76%?77.3%?50%. chemotherapy group and radiation therapy and chemotherapy group is higher than Surgery group and radiation therapy group (P<0.05); and89%.5year OS is60.2%and89%.5year PFS is59.1%?87%. The4-6courses of chemotherapy is higher than<4courses (P<0.05).There is no significant different between postoperative chemotherapy radiotherapy group and postoperative radiotherapy chemotherapy group.Conclusion High-risk EC in early stage, chemotherapy group and chemotherapy and radiation therapy group improve OS and PFS,the4-6crouses is better. There is no significant different between chemotherapy group and chemotherapy radiotherapy group. Objective To assess the clinical effectiveness of adjuvant chemotherapy for the high-risk early stage endometrial carcinomal. Method The following electronic dataases were searched:MEDLINE, EMBAS, Cochrane Library, Ovid database,Weipu Chinese periodical database. Correlative websites,such as'google', were searched by hand. The studies include in the references of eligible studies were additionally searched RCTs of adjuvant chemotherapy before September,2010comparing with surgery only were include. Eligible RCTs were assed for quality by two reviewers independently: criteria of concealment of treatment, blinding, standard validity and reliability of outcome measure, withdraw rate, intention-to-treat analysis between centers were analyzed for each study. All data were performed by a meta-analysis. Result Nine RCTs met the inclusion criteria/Methodological quality was level B. Four RCTs were compared adjuvant radiotherapy with surgery. Two RCTs were compared adjuvant chemotherapy with surgery. There is more survival in chemotherapy than surgery. Three RCTs were compared adjuvant radiotherapy with adjuvant chemotherapy. NO overall survival and desease-free survival rate differents were identified. Conclusion Adjuvant chemotherapy for high-risk early stage endometrial carcinomal can improve overall survival and desease-free survival rate. Stage endometrial carcinoma are need to further assessed by rigorously designs, randomized, double-blind, placebo-controlled trials adjuvant chemotherapy for endometrial carcinomal.