Estramustine phosphate in the treatment of endometrium carcinoma

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To study the clinical effects and side effects of Estramustine phosphate (EMP) on the treatment of endometrial carcinoma. Methods: Fifty-eight patients with endometrial carcinoma diagnosed in our hospital from Oct. 1996 to Feb. 1998 were randomly divided into 3 groups and clinically observed. EMP group (n=21): after oral EMP 280 mg, bid, for 21 days, surgical operation followed in one week. Radiotherapy (RT) group (n=19): surgical operation was preformed after intra-cavity irradiation with half of the standard dosage. Control group (n=18): surgical operation alone. Histopathological changes in the samples from the removed uterus were observed. Estrogen receptor/progestin receptor (ER/PR) and nuclear proliferate antigen (ki-67) index of the endometrial carcinoma tissues of the EMP group were tested by immunohistochemical methods. Results: The microscopic changes induced by irradiation were much heavier than those induced by chemotherapy. In EMP group, 5/21 cases were found with no tumor lesion in the postoperation samples, all of those 5 cases being with ER strong positive (++) and 4/5 cases well differentiated tumor before chemotherapy. In RT group, the tumor lesion was disappeared in 6/19 cases, and 5 cases of which being with the moderate differentiation. No significant difference was shown between those two groups. No any histopathological changes were seen in control group. Immunohistochemical tests revealed a significant decrease in ER staining after EMP treatment and a decrease in ki-67 index, especially for the ER positive tumors, ki-67 index reduced significantly from 49.5% before medication to 35.1% after medication (P
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