化疗同步光动力治疗对激素治疗失败子宫内膜癌患者生育功能的保留作用

　　The Effect of Concurrent Chemo-Photodynamic Therapy(CCPDT) in the case of failure of Hormon therapy in endometrial cancer for sparing fertility

　　T.G. Ahn, S.J. Han

　　Chosun University Hospital, Gwang Ju, Republic of Korea

　　Introduction: Progestin has been used for sparing fertility in endometrial cancer. But when the hormone treatment fails, the classical methods as like surgery, chemotherapy and radiation should be performed. Howerver these methods are not suitable in young women who want to preserve their fertility. Thus, we performed the photodynamic therapy with chemotherapy, which can remove the lesions and preserving fertility at the same time.

　　Methods: Two endometrial cancer patients (stage 1A, G1 and G2) who failed the treatment with Medroxyprogesterone Acetate(MPA) were selected. We used photodynamic therapy with carboplatin for treatment (Concurrent Chemo-Photodynamic Therapy, CCPDT). A photosensitizer (2.0mg/Kg, Photogem^TM[HpD], FINE chemical, Russia) was injected 48hours prior to PDT followed by administration of carboplatin(75mg/m² IV) 3 hours before PDT. Then, we applied a non-thermal laser light (CERALASTM Diode Laser 632 System, biolitec, Germany) 250J/Cm² in the endometrium.

　　Results: All tests for endometrial cancer which were performed every 3 months showed complete regression in two patients. More than 50 months has been passed and so far, there was no evidence of recurrence. One of those delivered a child and the other try to get pregnant now.

　　Conclusion: Unlike the traditional cancer therapy, the CCPDT could cure the selective lesions without any destruction of reproductive organ simultaneously maintaining the fertility. Therefore, we can suggest that CCPDT could be an optional solution in the case of unresponsive result with hormonal therapy in the endometrial cancer patients who wants to get pregnant. However, we think that further clinical studies should be required.

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