臨床婦人科産科75巻3号

2021年04月発行

今月の臨床 女性のライフステージごとのホルモン療法―この1冊ですべてを網羅する 腫瘍

子宮体がん

著者： 太田剛¹

所属機関： ¹山形大学医学部産婦人科

ページ範囲：P.363 - P.368

●子宮体がんの黄体ホルモン療法の適応は，妊孕性温存希望がある類内膜癌G1相当の患者とエストロゲン受容体・プロゲステロン受容体陽性の進行・再発がんの患者である．

●妊孕性温存療法としての黄体ホルモン療法では，メトホルミンやLNG-IUSの併用投与も行われる．

●進行・再発がんに対するホルモン療法としては，黄体ホルモン療法のほかにアロマターゼ阻害薬や選択的ER調整薬などがある．

参考文献

1）日本婦人科腫瘍学会（編）: 子宮体がん治療ガイドライン2018年版第4版．金原出版，2018

2）Uterine neoplasms（Version 1. 2018）NCCN Clinical Practice Guidelines in Oncology. 2018

3）Gunderson CC, et al : Oncologic and reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 adenocarcinoma : a systematic review. Gynecol Oncol 125 : 477-482, 2012

4）Ushijima K, et al : Multicenter phase II study of fertility-sparing treatment with medroxyprogesterone acetate for endometrial carcinoma and atypical hyperplasia in young women. J Clin Oncol 25 : 2798-2803, 2007

5）Colombo N, et al ; ESMO-ESGO-ESTRO Endometrial Consensus Conference Working Group : ESMO-ESGO-ESTRO consensus conference on endometrial cancer : diagnosis, treatment and follow-up. Int J Gynecol Cancer 26 : 2-30, 2016

6）Mitsuhashi A, et al : Phase II study of medroxyprogesterone acetate plus metformin as a fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer. Ann Oncol 27 : 262-266, 2016

7）Kim MK, et al : Combined medroxyprogesterone acetate/levonorgestrel-intrauterine system treatment in young women with early-stage endometrial cancer. Am J Obstet Gynecol 209 : 358.e1-e4, 2013

8）鈴木　直，他（編）/日本がん・生殖医療学会（監） : がん・生殖医療　妊孕性温存の診療，新版．pp259-267，医歯薬出版，2020

9）Rodolakis A, et al : European Society of Gynecological Oncology Task Force for Fertility Preservation : Clinical recommendations for fertility-sparing management in young endometrial cancer patients. Int J Gynecol Cancer 25 : 1258-1265, 2015

10）Kauppila A : Oestrogen and progestin receptors as prognostic indicators in endometrial cancer. A review of the literature. Acta Oncol 28 : 561-566, 1989

11）Thigpen T, et al : Tamoxifen in the treatment of advanced or recurrent endometrial carcinoma : a Gynecologic Oncology Group study. J Clin Oncol 19 : 364-367, 2001

12）Whitney CW, et al : Phase II study of medroxyprogesterone acetate plus tamoxifen in advanced endometrial carcinoma : a Gynecologic Oncology Group study. Gynecol Oncol 92 : 4-9, 2004

13）Fiorica JV, et al : Phase II trial of alternating courses of megestrol acetate and tamoxifen in advanced endometrial carcinoma : a Gynecologic Oncology Group study. Gynecol Oncol 92 : 10-14, 2004

14）Rose PG, et al : A phase II trial of anastrozole in advanced recurrent or persistent endometrial carcinoma : a Gynecologic Oncology Group study. Gynecol Oncol 78 : 212-216, 2000

15）Emons G, et al : Phase II study of fulvestrant 250mg/month in patients with recurrent or metastatic endometrial cancer : a study of the Arbeitsgemeinschaft Gynäkologische Onkologie. Gynecol Oncol 129 : 495-499, 2013

16）Thigpen JT, et al : Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma : a dose-response study by the Gynecologic Oncology Group. J Clin Oncol 17 : 1736-1744, 1999

17）Lentz SS, et al : High-dose megestrol acetate in advanced or recurrent endometrial carcinoma : a Gynecologic Oncology Group study. J Clin Oncol 14 : 357-361, 1996

18）Thigpen T, et al : Tamoxifen in the treatment of advanced or recurrent endometrial carcinoma : a Gynecologic Oncology Group study. J Clin Oncol 19 : 364-367, 2001

19）Marabelle A, et al : Efficacy of pembrolizumab in patients with noncolorectal high microsatellite instability/mismatch repair-deficient cancer : results from the phase II KEYNOTE-158 study. J Clin Oncol 38 : 1-10, 2020