Tazi Y, Pautier P, Leary A, Lhomme C
Comité de Gynécologie, Institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
Gynecol Obstet Fertil. 2013 Oct;41(10):611-6. doi: 10.1016/j.gyobfe.2013.08.008. Epub 2013 Oct 2.
Chemotherapy is fundamental in the management of epithelial ovarian carcinomas both for early and advanced stages (rarely surgical treatment alone) and in almost every step of the disease. The reference schema combines carboplatin and paclitaxel intravenously. Intraperitoneal chemotherapy also proved its efficacy after complete surgery for advanced disease and should be reserved to trained teams due to its technical constraints and toxicity issues. Modalities of treatment in relapsed and progressive disease depend mainly on the free interval between this diagnosis and the last dose of platinum. Bevacizumab has proven its effectiveness in prolonging progression-free survival in 1st line setting in association with chemotherapy followed by maintenance and in case of relapse or progression both fore platinum sensitive or resistant disease. Finally, a better understanding of ovarian cancer biology will allow us to consider new molecular-targeted agents guided by the specific characteristics of each patient and each tumor.
化疗在早期和晚期上皮性卵巢癌的治疗中都至关重要(很少单独进行手术治疗),并且贯穿疾病的几乎每个阶段。参考方案是静脉联合使用卡铂和紫杉醇。对于晚期疾病,腹腔内化疗在完全手术后也证明了其疗效,但由于其技术限制和毒性问题,应由专业团队实施。复发和进展期疾病的治疗方式主要取决于本次诊断与最后一剂铂类药物之间的无瘤间期。贝伐单抗已证明其在一线治疗中与化疗联合使用并随后进行维持治疗时,以及在复发或进展时(无论铂敏感或耐药疾病)延长无进展生存期的有效性。最后,对卵巢癌生物学的更好理解将使我们能够根据每位患者和每个肿瘤的具体特征考虑使用新的分子靶向药物。