Krasner Carolyn, Duska Linda
Division of Medical Oncology, Massachusetts General Hospital, Boston, MA 02114, USA.
Semin Oncol. 2009 Apr;36(2):91-105. doi: 10.1053/j.seminoncol.2008.12.001.
Ovarian cancer is the leading cause of death from gynecologic cancers in the United States. Initial management is reviewed here and is best provided by a multidisciplinary team, including a gynecologic oncologist and a medical oncologist. Typically these patients are first treated with aggressive surgical debulking, followed by chemotherapy. Exceptions to this strategy, including those for patients adequately treated with surgery alone and those better served by neoadjuvant chemotherapy (NAC), are discussed. The history and rationale of current chemotherapy regimens, both intravenous (IV) and intraperitoneal (IP), are reviewed. Given the chemo-sensitive nature of this disease, as well as the fact that it remains largely incurable in advanced stages, efforts continue to be made to improve initial therapy. This disease represents an excellent target for new drug development, and some of the newer agents in trials for ovarian cancer are discussed.
卵巢癌是美国妇科癌症死亡的主要原因。本文回顾了其初始治疗方法,最好由多学科团队提供,包括妇科肿瘤学家和医学肿瘤学家。通常这些患者首先接受积极的手术减瘤,然后进行化疗。讨论了该策略的例外情况,包括仅通过手术得到充分治疗的患者以及更适合新辅助化疗(NAC)的患者。回顾了当前静脉内(IV)和腹腔内(IP)化疗方案的历史和基本原理。鉴于这种疾病对化疗敏感的性质,以及它在晚期仍基本无法治愈的事实,人们继续努力改进初始治疗。这种疾病是新药开发的理想靶点,并讨论了一些正在进行卵巢癌试验的新型药物。