复发性卵巢癌的诊治进展.pdfVIP

复发性卵巢癌的诊治进展 中文摘要 在妇科恶性肿瘤中，卵巢癌是造成死亡原因最高的一种肿瘤。虽然临床常用 的治疗方案是理想的肿瘤细胞减灭术并辅以铂类加紫杉醇的术后系统化疗, 这使 部分卵巢癌患者的预后有了较大改善，但仍有约70%的患者出现了复发。复发是卵 巢癌患者预后差的主要原因。影响卵巢癌复发的相关因素主要有临床分期、细胞 分级、术后残留灶大小、术后化疗的规范化以及淋巴结情况等，了解这些相关因 素有助于早期诊断复发性卵巢癌。加强卵巢癌治疗后的监测，能够及早发现可疑 复发征象，及时进行合理治疗。临床卵巢癌监测手段有体格检查、CA125和HE4 检 测、超声、CT、MRI以及PET/CT。及时、准确地诊断复发性卵巢癌是进行合理个 体化治疗的基础。目前，对于复发性卵巢癌的治疗尚无最佳方案，临床处理较为 棘手。根据患者的个体情况选择合理的治疗方案，最大程度的延长患者的生存期， 改善患者的生存质量是主要的治疗目的。近年来，随着医学科技的发展，手术技 术、化疗方案及新药物的应用都有了良好的进展。分子靶向治疗、基因治疗、免 疫治疗等也展现出了广阔的前景。本文就复发性卵巢癌的定义、分型、影响复发 的因素、治疗时机、治疗方案等现状和发展动态进行综述，以期为复发性卵巢癌 的诊治提供更多的参考。 【关键词】卵巢癌；复发；二次肿瘤细胞减灭术；化学治疗；生物治疗 1 Diagnosisandtreatmentadvancesinrecurrentovarian cancer Abstract In gynecological malignancies , the highest causes of death is ovarian cancer. Optimal primary cytoreductive surgery ,which aided with platinum plus paclitaxel postoperative systemic chemotherapy, is commonly used in clinical treatment, and it has greatly improved the prognosis of ovarian cancer sufferers. But there are still about 70% of the patients with relapse. Relapse is the main reason for the poor prognosis of the patients with ovarian cancer.The main influencing factors of recurrent ovarian cancer are clinical stage, histological grade , the size of the residual tumor after surgery, postoperative chemotherapy of standardization and lymph nodes , etc. Understand these factors contribute to the early diagnosis of recurrent ovarian cancer. Strengthen the monitoring after the treatment of ovarian cancer, enable to find suspected recurrent signs earlier and carry on reasonable treatment timely. Monitoring tools of ovarian cancer, include medical examination, antigen 125 (CA-125) and HE4 detection,ultrasound examination,computed tomography (CT), magnetic resonance imaging(MRI) and PET/CT. The basis of reasonable individualized treatment of recurre