Schink J C
Department of Obstetrics and Gynecology, University of Wisconsin Comprehensive Cancer Center, Madison 53792, USA.
Semin Oncol. 1999 Feb;26(1 Suppl 1):2-7.
Patients with advanced ovarian cancer (International Federation of Gynecology and Obstetrics stage III or stage IV) have improved their long-term prognosis, but the majority will still die of their disease. The current standard therapy, which involves aggressive cytoreductive surgery (removal of all visible tumor) followed by platinum/paclitaxel chemotherapy, has increased 5-year survival rates considerably over the last three decades. The choice of treatment for patients with stage III or IV disease in the managed care setting must consider survival rates, patient quality of life, and cost-effectiveness. Two chemotherapy combinations, cisplatin/paclitaxel and carboplatin/paclitaxel, appear comparable in efficacy in advanced disease, but are currently being investigated in clinical trials to compare side effects, quality-of-life parameters, and cost-effectiveness. The results of these trials may determine which chemotherapy combination becomes the standard of care for first-line treatment. Managed care organizations and patients can also benefit from a multidisciplinary approach to cancer care that includes additional support, such as risk assessment programs, the use of specialists (gynecologic oncologists), and psychosocial counseling. As the search for more effective agents and other therapeutic modalities continues, the focus of future research may be to find specific biomarkers of ovarian cancer, which will help detect disease at its earliest stages.
晚期卵巢癌患者（国际妇产科联盟分期为III期或IV期）的长期预后有所改善，但大多数患者仍会死于该疾病。目前的标准治疗方法是先进行积极的细胞减灭术（切除所有可见肿瘤），然后进行铂类/紫杉醇化疗，在过去三十年中，5年生存率显著提高。在管理式医疗环境中，为III期或IV期疾病患者选择治疗方法时，必须考虑生存率、患者生活质量和成本效益。两种化疗方案，顺铂/紫杉醇和卡铂/紫杉醇，在晚期疾病中的疗效似乎相当，但目前正在进行临床试验，以比较副作用、生活质量参数和成本效益。这些试验的结果可能会确定哪种化疗方案成为一线治疗的标准。管理式医疗组织和患者也可以从癌症护理的多学科方法中受益，这种方法包括额外的支持，如风险评估项目、专科医生（妇科肿瘤学家）的使用和心理社会咨询。随着对更有效药物和其他治疗方式的探索不断继续，未来研究的重点可能是寻找卵巢癌的特定生物标志物，这将有助于在疾病的最早阶段进行检测。
