Ovarian cancer treatment, the general principle of treatment is surgical combined therapy. According to their histological type and clinical stage, choose a different tube treatment.
(A) Surgical treatment of ovarian
Surgery is the most important means of ovarian cancer, the tumor can not be estimated unless the clinical and surgical resection Xin taboo, or should be the first surgery. There are several different surgical procedures:
(1) comprehensive staging laparotomy to determine: for I the preoperative diagnosis of ovarian cancer patients. Including the full removal of the uterus and two annexes, omental resection, pelvic and para-aortic lymphadenectomy, peritoneal cytology (abdominal or pelvic East, peritoneal fluid).
(2) cytoreductive surgery: Case for E of the above. The concept is to surgical tumor (including the transfer of baby) or basic cut most of the net cut net. Satisfaction or success of cytoreductive surgery with residual foci of each individual lesion diameter <2cm as the standard. The ideal completion of cytoreductive surgery, is conducive to the recovery of the body anti-tumor immunity, in order to put, IT and other technology to create favorable conditions.
(3) secondary duct exploration: line cytoreductive success 1 year after operation, and implementation of at least six courses of chemotherapy, clinical examination and laboratory examinations (including CA125 and other tumor markers) were normal, re-laparotomy duct exploration. The aim is to provide stop chemotherapy or chemotherapy and treatment to change the basis for exploration and removal of foci seen.
Ovarian cancer is not only to cure by surgery, cancer chemotherapy is the principle of comprehensive treatment of ovarian cancer in an important and indispensable measures, implemented a successful cytoreductive surgery are more effective.
Treatment of ovarian cancer (b) radiation therapy for ovarian cancer
Most ovarian tumors of low sensitivity to radiation alone, radiation therapy is not the primary means of treatment. Among them, ovarian dysgerminoma highly sensitive to radiation, can be cured by radiotherapy.
Ovarian cancer is a common gynecologic malignancy in the worst effect of those, particularly poor prognosis in patients with advanced, five-year survival rate remained at 20% number_30%. I, H, N III, and five-year survival rates of ovarian cancer were 86%, 50%, 19% and 3%. Prognostic factors: clinical stage, histological type, histological grade, surgery and postoperative residual tumor size and number of chemotherapy treatments. Such as the different histological types of tumors in different five-year survival rate, 15% serous carcinoma number_30%, mucinous cystadenocarcinoma is 40% _50%, the prognosis is better than serous carcinoma, the clinical development process is slower. Endometrial cancer, 40% five-year survival rate was _55%, 13% embryonal carcinoma, immature teratoma of up to 63%. Looking for early diagnosis, improve rates of early diagnosis, efforts to effect a successful cytoreductive surgery and chemotherapy treatment on schedule to complete enough way to improve the prognosis.
(C) of the ovarian cancer chemotherapy
(1) first-line:
6 cycles of standard treatment. Of epithelial ovarian cancer should be preferred TP program, the paclitaxel 135-175 mg/m2, Jiaka lead AUC = 6 or DDP75mg/m2. PAC and PC programs can also choose that card lead AUC = 6, or DDP 70-100mg / m2, stomach ADM 50mg/m2 or epirubicin 80mg/m2, cyclophosphamide Air plastic 750mg / when the three drugs, or both drugs in combination.
Malignant germ cell tumors and sex cord stromal tumors with VAC and the VBP program as first-line, vincristine 2mg, actinomycin D1.5-2.5mg, cyclic plastic 750mg/m2, bleomycin 45mg, DD P70-100mg/m20VAC I of the program is mainly used in cases of minor side effects. VPB program can use the advanced cases in significantly improved efficacy and reproductive function preserved.
(2) second-line program
Uncontrolled cases of recurrence and may make use of the following drugs: Topology for the team is willing to Topoteca Taxol Paclitaxel, Docetaxel Docetaxel, different cyclic plastic Ifosfamide, gemcitabine Gemeiabine, liposomal doxorubicin Doxil, lead acid Oxaliplatin, foot Ye B test (VP16) oral capsules.
Treatment of ovarian cancer (3) ways and means of administration
In general, more use of postoperative intraperitoneal and intravenous chemotherapy. Addicted to the abdominal pelvic ovarian cancer spread, intraperitoneal administration is particularly important. Delivery methods are single-needle method and stay catheter method, the former method is more safe and easy, no catheter blockage and infection complications. Intraperitoneal fluid was about 2000, so that uniform distribution of drug in the abdominal cavity. In addition, arterial infusion chemotherapy can, from the inferior epigastric artery, uterine artery catheterization, or percutaneous femoral artery puncture to the times of chemotherapy, aimed at increasing times of drug concentration in arterial blood can be used to control the pelvic floor or lesions around the vaginal stump. After the right gastroepiploic artery to the hepatic artery or percutaneous femoral artery catheterization of hepatic artery chemotherapy, to treat liver metastases. General 6_8 course of treatment. The common toxicities of chemotherapy were myelosuppression, gastrointestinal tract, renal toxicity and alopecia.