Table 3.

Experimental and clinical studies of hormonal therapy to treat uterine cancer.

Name of Hormone	Formulation Name and Dose	Observation Time	Study Model	Results	References
Aromatase Inhibitor	Anastrozole (1 mg/day), exemestane (25 mg/day)-1 patient, letrozole (2.5 mg/day)	29.2 months	Patients with uterine sarcoma (4 patients with ESS, endometrial stromal sarcoma, and 3 patients with LMS)	Effective in the treatment of endometrial stromal sarcomas	[117]
Progesterone	Medroxy progesterone acetate (36 patients; 44%) or megestrol acetate(28 patients; 35%), progestins	24weeks	81 patients	When disease recurs, carcinoma extending beyond the uterus is rare in patients reported with well-differentiated endometrial adenocarcinoma who undergo treatment with a progestational agent	[123]
Estrogen, progestin, aromatase inhibitors	ERT, tamoxifen, progestins, aromatase inhibitors	4 to 164 months	800 patients	MPA and letrozole, in particular, are highly effective and lead to sustained disease control in most cases	[120]
Progestin, Aromatase inhibitors	Megestrol acetate (MA), Aromatase inhibitor (letrozole)	4+ to 252+ months (median 48+ months).	11 patients	Hormonal treatment for measurable residual or recurrent low-grade ESS has a high response rate and should be considered as the treatment of choice for patients in which recurrent disease cannot easily be eliminated	[122]
Exogenous or endogenous estrogen and progestins	Megestrol acetate 160 mg, progestins	100 months (range, 2–258)	22 patients	ERT was detrimental in patients with low-grade endometrial stromal sarcoma, but progestin therapy should be routinely considered for adjuvant therapy and for the treatment of recurrent endometrial stromal sarcomas	[124]
Progesterone	Medroxy progesterone acetate (MPA)	Dosing period 64 months (range 28–92 months) but follow-up period was 117 months	13 patients	MPA therapy might be considered as a therapeutic option for residual or recurrent low-grade ESS and perhaps chosen as a first-line therapy	[125]
Aromatase	Aromatase inhibitors used were letrozole (in 74% of patients), anastrozole (21%), and exemestane (6%)	Between 1998 and 2008	40 patients	Aromatase inhibitors achieved objective response in only 9%. Progression free survival was longer among patients with ER and/or PR positive tumors than among patients with ER and PR negative tumors	[126]
GnRH agonist	GnRH agonist, leuprolide acetate, adriamycin, cisplatin, ifosfamide etc.	15 months	A patient with menorrhagia, dysmenorrhea, and an enlarged uterus	GnRH therapy mask the symptoms of leiomyosarcomas, e.g., rapidly enlarging uterine mass, pelvic pain, uterovaginal bleeding	[133]
Progestin and aromatase	Three cycles of BEP (bleomycin, etoposide, cisplatin), anastrozole and megestrol acetate	2 years	48-year-old woman was diagnosed with stage I endometrial stroma sarcoma	Endometrial stromal sarcoma with sex-cord stromal component may be hormonally functional and can be cured by treating with progestin and aromatase inhibitor	[127]
Estrogen, progesterone	Megestrol acetate and tamoxifen	6 months	A 22-year-old nullipara	1 year after the last curettage, there is no evidence of disease	[130]
Estrogen, progesterone	Combinations of megestrol acetate (160 mg/day), tamoxifen (30 mg/day), and GnRHa	6 months	9 patients with clinically diagnosed endometrial adenocarcinoma stage IA, grade 1	Of the 9 patients, 8 (88.9%) achieved complete remission after hormone therapy. All nine patients have been alive without evidence of disease	[129]
Estrogen, progesterone, (GnRHa)	Megestrol (1-month), tamoxifen (20 mg/day) and depot leuprolide acetate subcutaneous injection (3.75 mg/month)	6-months	A 36-year-old nulliparous woman	This case report signals a warning that negative clinical investigations are not reassuring for a relapsing endometrial adenocarcinoma failing conservative hormonal treatment	[131]
Estrogen, progestin	500 mg of oral medroxyprogesterone for 6 months, twice weekly	9 months (range, 3–18 months)	2 women	The quarterly interval for D&Cs was satisfactory with medroxyprogesterone treatment, and the patients’ desire not to undergo hysterectomy was met	[132]