Present an integrated treatment of ovarian cancer to surgical treatment, adjuvant chemotherapy is of great significance, with the discretion given radiotherapy, and then to biological factors or to consolidate the curative effect of traditional Chinese medicine.
1. Epithelial ovarian cancer treatment
Preferred surgery plus postoperative chemotherapy or radiotherapy and biological factors and traditional Chinese medicine.
(1) early epithelial ovarian cancer surgical therapy. Commonly used surgical accessories for the whole double uterus and omentum resection. Poor differentiation of pathology, retroperitoneal lymph nodes and other high-risk cases should be performed to determine a comprehensive staging laparotomy.
Should be used after surgery to shun uranium-based program (such as the PC program) 6 cycles of chemotherapy: no precise surgical staging (no line omentum resection and / or retroperitoneal pelvic lymph node dissection). clear cell carcinoma. the surface of ovarian tumor growth (Ie). tumor capsule rupture or incomplete. tumor and pelvic adhesions.
(2) treatment of advanced epithelial ovarian cancer cytoreductive surgery of choice. All of the abdominal metastases resection as possible, so that residual foci under the diameter of not more than a single 2cm, combined with chemotherapy after 6 – 8 courses, choose the route of administration or systemic administration of the abdominal cavity, pelvic arterial infusion and radiotherapy, where appropriate, biological factor in the treatment and Chinese medicine treatment. Those that can not be removed, chemotherapy may be an early 1 – 2 after treatment, tumors can be estimated that surgical resection, postoperative combined with chemotherapy, radiotherapy, immunotherapy and Chinese medicine treatment.
2. Non-treatment of epithelial ovarian cancer
(1) class of germ cell malignancies, including dysgerminoma, malignant teratoma, etc., is a highly malignant tumor, but sensitive to chemotherapy, including dysgerminoma particularly sensitive to radiotherapy. As dysgerminoma occur in young people aged under 20 accounted for 75%, while the radiation induced malformation of young people possible, so choose radiation therapy should be careful. Conventional surgery is the removal of these tumors double attachment hysterectomy, omental and para-aortic lymph nodes for biopsy, chemotherapy given after 4 – 6 courses of treatment. I can also remove the affected side of patients with accessories, omental and retroperitoneal lymph nodes; E, N of patients, if the uterus and normal contralateral attachment, possible metastases resection, omentum, and retroperitoneal lymph node dissection, the uterus and the retained side of the ovary.
(2) the majority of sex cord stromal tumors are benign, benign ovarian tumors by treatment. Others are low or potentially malignant, and of such principles as: I a of the young patients unilateral oophorectomy or determine the staging surgery. Ib or I c of family planning has been completed to determine staging surgery patients. Ie, E, E, N on-line cytoreductive surgery, 6 courses of chemotherapy were given postoperatively.
3. The treatment of recurrent ovarian cancer
Combined therapy should be used, and according to the different parts of relapse choose different treatment modalities.
(1) abdominal, pelvic recurrence can be resected should be removed as far as possible, after limited pelvic recurrence of dysgerminoma, granulosa cell tumor and serous cell carcinoma pelvic radiotherapy complement of embryonal carcinoma, choriocarcinoma, or abdominal cavity kitchen wall recurrence were given intraperitoneal chemotherapy.
(2), vagina, vulva, or pelvic recurrence advance extraperitoneal pelvic arterial chemotherapy, then surgery. Vaginal lesions can be used brachytherapy.
(3) more extensive occurrence of systemic metastasis, such as lung, liver, etc. transfer to systemic chemotherapeutic regimens.