METHODS: Patients with EC who received high-dose medroxyprogesterone (MPA) at our Hospital between January 2010 and December 2022 were reviewed. Patients who were treated for fertility preservation or had a history of systemic chemotherapy other than adjuvant therapy were excluded.
RESULTS: Sixteen patients who were eligible for study inclusion had recurrent G1 or G2 EC. Their median age was 65 years (range=51-82 years), median body mass index was 22.6 kg/m2 (range=15.3-43.2 kg/m2), and all patients had an ECOG Performance Status of 0. All patients received 200 mg/day of MPA, and eight patients concomitantly received 100 mg/day of aspirin. None of the patients experienced severe adverse events. One patient had grade 2 deep vein thrombosis. Two patients discontinued MPA treatment because of adverse events. The response rate was 44% [95% confidence interval (CI)=20-68%] and median progression-free survival (PFS) was 6.9 months (95% CI=7.5-26 months). Four of 16 patients had PFS longer than 12 months, all of whom had positive tissue estrogen receptor (ER) and progesterone receptor (PR), and PFS at 2 years was 35% (95% CI=10.2-59.8%).
CONCLUSIONS: Hormone therapy is effective long-term in ER- and PR-positive EC and can be recommended as initial systemic therapy. Toxicity is mild and manageable.
方法:回顾了2010年1月至2022年12月在我们医院接受高剂量甲羟孕酮(MPA)治疗的EC患者。排除接受生育力保留治疗或有除辅助治疗外的全身化疗史的患者。
结果:16例符合纳入研究条件的患者有复发的G1期或G2期EC。他们的中位年龄为65岁(范围=51-82岁),中位体重指数为22.6kg/m2(范围=15.3-43.2kg/m2),所有患者的ECOG表现状态均为0。所有患者接受200毫克/天的MPA,8例患者同时接受100mg/天的阿司匹林。没有患者经历严重的不良事件。一名患者患有2级深静脉血栓。两名患者因不良事件而停止MPA治疗。缓解率为44%[95%置信区间(CI)=20-68%],中位无进展生存期(PFS)为6.9个月(95%CI=7.5-26个月)。16例患者中有4例PFS超过12个月,所有这些人都有阳性的组织雌激素受体(ER)和孕激素受体(PR),2年PFS为35%(95%CI=10.2-59.8%)。
结论:激素治疗对ER和PR阳性的EC长期有效,可推荐作为初始全身治疗。毒性是温和和可控的。