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[上皮性卵巢癌的治疗]

[Treatment of epithelial ovarian cancer].

作者信息

Langmár Zoltán, Csömör Sándor

机构信息

Altalanos Orvostudományi Kar, II. Szülészeti és Nogyógyászati Klinika, Budapest.

出版信息

Orv Hetil. 2006 Aug 27;147(34):1627-32.

Abstract

Epithelial ovarian cancer is the most lethal gynecological cancer among women. The median age at diagnosis is 63 years. The vast majority of patients present with advanced disease and require a combination of cytoreductive surgery and adjuvant chemotherapy. Important features that determine the outcome of treatment include the stage of disease, hystological type, grade and the size of the residual tumour after initial surgery. Current guidelines recommend that standard first-line chemotherapy should include a platinum-based regimen with paclitaxel. Despite the combined therapy, over 50% of all the patients has relapse. Relapsed ovarian cancer is incurable, however chemotherapy can improve quality of life and survival. Currently, there is no worldwide accepted standard treatment for patients with platinum-refractory ovarian cancer. Docetaxel, topotecan, gemcitabine, pegylated liposomal doxorubicin, etoposide and tamoxifen can be used in this group. However response duration rarely exceeds 12 months. Intraperitoneal chemotherapy, gene therapy, immunotherapy, signal transduction inhibitors (trastuzumab) and angiogenesis inhibitors (bevacizumab) are all potential future therapies, and are being investigated in ongoing clinical research. In this publication authors review the literature of current treatment options in epithelial ovarian carcinoma.

摘要

上皮性卵巢癌是女性中最致命的妇科癌症。诊断时的中位年龄为63岁。绝大多数患者就诊时已处于晚期,需要进行减瘤手术和辅助化疗相结合的治疗。决定治疗结果的重要因素包括疾病分期、组织学类型、分级以及初次手术后残留肿瘤的大小。当前指南建议,标准的一线化疗应包括含铂方案联合紫杉醇。尽管采用了联合治疗,但所有患者中仍有超过50%会复发。复发性卵巢癌无法治愈,不过化疗可以改善生活质量并延长生存期。目前,对于铂类难治性卵巢癌患者,尚无全球公认的标准治疗方法。多西他赛、拓扑替康、吉西他滨、聚乙二醇脂质体阿霉素、依托泊苷和他莫昔芬可用于这组患者。然而,缓解持续时间很少超过12个月。腹腔内化疗、基因治疗、免疫治疗、信号转导抑制剂(曲妥珠单抗)和血管生成抑制剂(贝伐单抗)都是未来潜在的治疗方法,目前正在进行的临床研究中进行探索。在本出版物中,作者回顾了上皮性卵巢癌当前治疗选择的文献。

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