Can endometrial cancer be cured by taking medicine

What is the best medicine for endometrial cancer? The treatment principle of endometrial cancer should be determined based on the clinical stage, the degree of differentiation of cancer cells, the patient's general condition and other factors. Because the vast majority of endometrial cancers are adenocarcinomas, which are not sensitive to radiotherapy, surgery is the main treatment, but drug therapy should also be used for comprehensive treatment.

1. Progestin drug therapy

It is mostly used for cases of recurrence or metastasis after surgery or radiotherapy, and is also used for patients with well-differentiated, early-stage, young adenocarcinoma who need to preserve fertility. Progestogens are recommended as a component of comprehensive treatment. Progestogens can also reduce the postoperative vaginal recurrence rate, so they can also be widely used as adjuvant treatment after surgery or radiotherapy.

The mechanism of action of progesterone in treating endometrial cancer is currently believed to be that it acts directly on tumor cells, causing them to transform from malignant to normal endometrium, inhibiting the synthesis of cancer cell DNA and RNA, reducing division, and thus inhibiting the reproduction of cancer cells. Finally, the tumor is replaced by hyperplastic or atrophic endometrium.

Commonly used drugs include: medroxyprogesterone acetate, megestrolacetate, 17-hydroxyprogesterone caproate, and norgestrel.

Medroxyprogesterone acetate: also known as medroxyprogesterone acetate. Short-acting can be taken orally; long-acting (depo-provera) is used for injection, 200-400 mg, intramuscular injection, twice a week, for 3-6 months, or after 12 weeks, change to a maintenance dose of 200 mg/d. Oral use is less common, usually for the first 5-6 weeks, at least 3 mg per week, and then 400 mg/d for long-term use. What is the best medicine for endometrial cancer?

Megestrol acetate: Trade name Funing Tablets, 40-160 mg/d, after oral administration for 12 weeks, change to maintenance dose of 500 mg, twice a week.

Progesterone acetate: 500 mg/d, intramuscular injection, once a day. After 12 weeks, change to 500 mg, twice a week, for a total of 6 months.

The objective efficacy of progestogen drugs in the treatment of endometrial cancer is 30-35%, and the sustained remission and even cure rate is about 90%. Progestogen drugs are non-cytotoxic drugs with high safety and little toxicity. Common side effects include mild water and sodium retention and gastrointestinal reactions, and other side effects include hypertension, acne, breast pain, etc. 0.6 may have allergic reactions, but no case has caused death. It should be used with caution in patients with damage to heart, liver, and kidney function.

2. Anti-estrogen drug treatment

Tamoxifen is a nonsteroidal anti-estrogen drug that has a slight androgenic effect. It competes with estradiol for estrogen receptors (ER), occupies the receptors and acts as an anti-estrogen.

The increase of PR in the tumor is conducive to progestin therapy. It is usually used in advanced cases, postoperative recurrence or metastasis. It can be used alone (progestin therapy is ineffective) or with pregnancy hormones, or in combination with chemotherapy drugs.

The dosage is 20 mg/d, taken orally. If the effect is not obvious after a few weeks, the dosage can be doubled. It has been reported that the loading dose for the first application is 80 mg/d. Side effects include nausea, vomiting, rash, hot flashes, bone marrow suppression, thrombocytopenia, vaginal bleeding, hypercalcemia, etc.

3. Chemotherapy drug treatment

It is mostly used for patients with advanced or recurrent metastasis. If there are conditions to measure PR and ER in cancer tissue, progesterone therapy is preferred when the receptor is positive; when the receptor is negative, chemotherapy is more often used. If there are no conditions to measure receptors, progesterone should be used if the cancer cells are well differentiated, and chemotherapy should be chosen if the differentiation is not good. 1. Single drug chemotherapy: 5-FU and CTX are more commonly used and have a more certain effect.

2. Combination chemotherapy: Multiple-drug combination chemotherapy replacing single chemotherapy is the trend of modern anti-cancer treatment. The combination chemotherapy regimens for endometrial cancer include:

(1) ADR (37.5 mg/m2) and CTX (500 mg/m2) were administered intravenously with an interval of 21 days between treatment courses. The objective effective rate was 62.5 (Muggia et al., 1977).

(2) DDP (60 mg/m2), ADR (50 mg/m2) and CTX (600 mg/m2), with an interval of 28 days between treatment courses, had an objective effective rate of 57.1 (Koretz et al., 1980).

(3) VCR (vincristine 1.5 mg), ADR (40 mg/m2), CTX (500 mg/m2) intravenously, plus 5-FU 500 mg/m2 intravenously for 2 days, with an interval of 21 days between treatments, with an objective effective rate of 50% (Kauppila et al., 1980). What is the best drug for endometrial cancer? Combination chemotherapy is more likely to be used simultaneously with progesterone drugs.