Chemotherapy of uterine endometrial cancer

In recent years, the incidence of endometrial cancer has tended to increase gradually in Japan. Most cases (early cancer of stage I and II) are treated by hysterectomy alone, and the prognosis has been relatively good. From analysis of the poor prognostic factors in endometrial cancer, we understood that additional therapy is necessary for patients who have the following factors: degree of differentiation: G3; invasion to > 1/2 myometrium; metastases to pelvic or para-aortic lymph node, isthumus-cervix extension; surgical stage III and more. However, for patients with advanced inoperable and recurrent cancer, a radiotherapy, is not so sensitive to endometrial cancer has been used. A first line establish a chemotherapy has not been established either. Various attempts have been made to establish a chemotherapy for endometrial cancer. As a result, adriamycin (ADR) and cisplatin (CDDP) have proved effective as single agents. For patients with early cancer who have the poor prognostic factors mentional above, irradiation and polychemotherapy regimens (CAP and AP) are effective. Since the progression of endometrial cancer is dependent on sex steroid hormones, antitumor effects of Medroxyprogesterone acetate (MPA) are expected to be effective for patients with estrogen receptor (ER) positive and progesterone receptor (PR) positive cancer, or with well-differentiated adenocarcinoma (G1 type) histologically. Although several forms of therapy are capable of inducing objective remission as adjuvant treatment, all treatment for advanced and recurrent disease remains palliative, and responses and survival for patients treated with irradiation and chemotherapy remain short. Furthermore, we should examine new methods such as new drug application of key drugs like ADR and Pt pharmaceutical preparation, improvement of Dose intensity of the key drugs and Biochemical modulation, CPT-11, Taxol and assembly of key drugs, along with the Circadian approach in the light of Biochronology.