ENDOMETRİUM KANSERİNDE RADYOTERAPİ- KEMOTERAPİNİN ROLÜ: RANDOMİZE ÇALIŞMALAR EŞLİĞİNDE DEĞERLENDİRME

Öz

Endometrium kanseri genellikle olguların erken evrede tanı alması nedeniyle iyi prognoza sahiptir. Pelvik radyoterapi (RT) evre I olgularda oldukça yüksek lokal kontrol oranları sağlarken, sağkalım avantajı yoktur. Yüksek ve orta riskli endometrium kanserinde ise RT ‘nin yeri sınırlıdır. Geleneksel olarak bu olgularda RT kullanılmasına karşın 5 yıllık sağkalım oranları %80’lerin altında kalmaktadır. Bu yüksek riskli ve ileri evre olgularda tedavi başarını arttırmak için adjuvan sistemik tedaviye ihtiyaç vardır. Endometrium kanserinde eskiden gelen genel görüş kemoterapiye dirençli olduğu yönünde olsa da günümüzde bu düşünce değişime uğramıştır. Tamamlanmış ve yürümekte olan çalışmalar kemoterapi ve RT’nin birlikteliğini, yalnız kemoterapi ya radyoterapinin rolünü açıklamaktadır. Bu derlemede randomize çalışmalar ışığı altında endometrium kanserinde kemoterapi ve radyoterapinin yeri araştırılmıştır.

Anahtar Kelimeler

• Endometrium Kanseri, Radyoterapi, Kemoterapi.

Öz

Endometrial carcer generally has a good prognosis because most cases are diagnosed in stage I. Pelvic radiotherapy (RT) for stage I endometrial cancer provides a highly significant improvement of local control, but without survival advantage. Use of adjuvant RT is limited to patients with high-intermediate or high risk factors. Despite a tradiational generous use of adjuvant radiotherapy those patients have less than an %80 5 year overall survival. In those high-risk patients and locally advanced endometrial carcinomas there is a need for systemic adjuvant therapy. Endometrial cancer has traditionally been thought to be a rather chemotherapy intensitive tumour, but gradually this view has changed. Current ongoing trials are exploring the role of combined radiotherapy and chemotherapy, compared to chemotherapy or RT alone. This is a review of the randomised studies carried out on adjuvant chemotherapy and radiotherapy in endometrial cancer

Anahtar Kelimeler

• Endometrial Cancer, Radiotherapy, Chemotherapy

Kaynakça

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