賀爾蒙治療在保留子宮的子宮內膜癌病人的角色

Hormonal therapy for young patients with endometrial cancers who need the preservation of the uterus

雖然標準治療子宮內膜癌的方法，主要以手術為主。但是少數在非常年輕還未生育的婦女身上發現了子宮內膜癌，那就極具挑戰性。傳統上，年輕婦女的子宮內膜癌的造成原因與雌激素脫不了關係，過多的雌激素在沒有適當的黃體素對抗下，發生增生甚至癌化的機率頗高，所以使用賀爾蒙，尤其是黃體素，或許在這類患者身上，可能是不得不然的首選藥物。所以關於使用賀爾蒙來治療子宮內膜癌並且有效的保留子宮，最後達到生育的目的，值得我們的探討。本文就針對這部分來作討論。

The relationship between hormones and endometrial cancer is well known, since excess estrogen, and unopposed estrogen use might lead to endometrial overgrowth, hyperplasia, and subsequent development of endometrial carcinoma. Therefore, the possibility of using anti-hormone therapy in endometrial carcinoma is always supposed. It is a big challenge in the young women with endometrial cancer who want to have the preservation of the uterus. Some critical points might help us in dealing with those patients, including (1) the oncologic risk; (2) appropriate candidates; (3) type of hormone use; (4) response rate of hormonal therapy; (5) appropriate surveillance; and (6) additional counseling for anxiety about relapse and metastasis, distress about side-effects, advice of the family, advice of the medical staff, and economic burden. A recent knowledge of the use of hormones in the management of younger women with endometrial cancer who want fertility preservation is provided.