ARCHIVEOBSTETRICS AND GYNECOLOGY
International Medical Journal, Vol. 26., Iss. 4, 2020, P. 38−41.
COMBINED TREATMENT OF PATIENTS WITH ENDOMETRIAL CANCER I-II (Т1-2N0M0) TAKING INTO ACCOUNT THE LEVEL OF EXPRESSION OF MOLECULAR BIOLOGICAL TUMOR MARKERS
SO "Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine", Ukraine
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.
1. Rak v Ukraїnі, 2017−2018. Zakhvoryuvanіst', smertnіst', pokazniki dіyal'nostі onkologіchnoї sluzhbi / uklad. Z. P. Fedorenko ta іn. // Byul. Natsіonal'nogo kantser−reєstru Ukraїni. K., 2019. № 20. 101 s.
2. Molekulyarnye markery raka sheiki matki i tela matki kak prognosticheskie faktory / M. R. Kairbaev i dr. // Klin. meditsina Kazakhstana. 2013. № 3. S. 42−46.
3. Teoreticheskie osnovy i prakticheskoe primenenie metodov immunogistokhimii: ruk. / D. E. Korzhevskii i dr.; pod red. D. E. Korzhevskogo. 2−e izd., ispr. i dop. SPb.: SpetsLit, 2014. 119 s.
4. Chepets A. V. Sravnitel'naya immunogistokhimicheskaya kharakteristika ekspressii prognosticheskikh markerov nemetastaticheskoi i metastaticheskoi invazivnoi adenokartsinomy tela matki // Zaporozhskii meditsinskii zhurn. 2016. № 5. S. 58−63.
5. Biologicheskie markery opukholei v klinike: dostizheniya, problemy, perspektivy / N. E. Kushlins'kii i dr. // Ros. bioterapevt. zhurn. 2009. № 3. S. 95−102.
6. Expression of ER, PR, C−erbB−2 and Ki−67 in Endometrial Carcinoma and their Relationships with the Clinicopathological Features / C. G. Yu et al. // Asian Pac. J. Cancer Prev. 2015. Vol. 16, № 15. P. 6789−6794. doi: https://doi.org/10.7314/apjcp.2015.16.15.6789
7. Expressions and clinical significance of COX−2, VEGF−C, and EFGR in endometrial carcinoma / S. Cai et al. // Arch. Gynecol. Obstet. 2017. Vol. 296, № 1. P. 93−98. doi: https://doi.org/10.1007/s00404−017−4386−9
8. Khokhlova S. V., Bazaeva I. Ya. Optimal'naya taktika ad"yuvantnogo lecheniya bol'nykh rakom tela matki // Farmateka. 2017. № 8. S. 29−35.
9. Bakhidze E. V., Belyaeva A. V. Khimioterapiya raka endometriya // Farmateka. 2017. № 8. S. 23−28.
10. Does early chemotherapy improve survival in advanced endometrial cancer / D. Boothe et al. // Am. J. Clin. Oncol. 2019. Vol. 42, № 11. P. 813−817.
11. Perivascular epithelioid cell tumor of the uterus with ovarian involvement: a case report and review of the literature / M. Fitzpatrick et al. // Am. J. Case Rep. 2016. Vol. 17. P. 309−314. doi: https://doi.org/10.12659/ajcr.896401
12. Metastatic endometrial cancer of the paranasal sinuses / A. Bashyam et al. // Ann. R. Coll. Surg. Engl. 2018. Vol. 100, № 7. P. e161−e164. doi: https://doi.org/10.1308/rcsann.2018.0078