摘要
卵巢癌是妇科三大肿瘤之一。因卵巢位于盆腔深部,卵巢癌患者多无明显症状,察觉时已是晚期。晚期卵巢癌恶性程度高,预后差,手术辅以化疗是目前主要治疗手段。手术中尽可能切除肿瘤、缩小残留病灶达到理想肿瘤细胞减灭术以延长生存期、改善预后。对于无法手术的晚期卵巢癌患者,新辅助化疗能够改善手术条件,增加手术满意度,是可行的治疗方案。因此,术前对晚期卵巢癌患者手术可行性进行评估,予以患者正确的首选治疗方案,提高手术满意度,避免不必要的剖腹探查。目前用以晚期卵巢癌肿瘤细胞减灭术术前评估的方法有1)影像学检查,如CT、PET,MRI等;2)CA125值,根据CA125值的高低评估手术可行性;3)腹腔镜探查,根据术中所见评估开腹手术可行性;4)其他各种肿瘤标记物如p53。各研究中探讨的手术评估手段大多局限于某一个方面,未能将有意义的预测因素全部纳入进行综合分析,准确性尚存在不足。探索新的方式方法,或是交叉应用两种或两种以上评估手段对晚期卵巢癌肿瘤细胞减灭术可行性进行综合评估,提高手术满意程度,缩小残留病灶,达到延长晚期卵巢癌患者生存时间和改善晚期预后的目的。本文就晚期卵巢癌肿瘤细胞减灭术可行性的评估和新辅助化疗的选择进行综述。
Ovarian carcinoma is one of the three common gynecological neoplasms. It typically develops as an insidious disease, with few warning signs or symptoms. By the time it is detected, it is usually in an advanced stage, with a poor diagnosis. Initial debulking surgery followed by chemotherapy is the current treatment for advanced ovarian carcinoma. Optimal eytoreduction can prolong survival time and improve prognosis. For patients with unresectable primary tumors, neoadjuvant chemotherapy can improve the conditions for surgery and the effect of eytoreduction. In order to optimize the conditions and avoid unnecessary laparotomies, it is important to evaluate tire feasibility of surgery and to select the proper methods of primary surgery and neoadjuvant chemotherapy for advanced ovarian carcinoma. At present, feasibility evaluation includes： 1） radiography, e.g., CT, PET and MRI; 2） CA125 value; 3） laparoscopic exploration; 4） other tumor markers such as p53. However, none of these methods can evaluate all of the factors influencing the outcome of cytoreduction to reach an across-the-board evaluation of the surgery. New methods and combination of two or more methods can optimize the procedure, reduce residual disease, improve prognosis and prolong survival time. In this article, advances in feasibility evaluations of cytoreduction for advanced ovarian carcinoma and the selection of neoadjuvant chemotherapy are reviewed.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2007年第22期1317-1320,共4页
Chinese Journal of Clinical Oncology
关键词
晚期卵巢癌
理想肿瘤细胞减灭术
新辅助化疗
Advanced ovarian carcinoma Optimal cytoreductionNeoadjuvant chemotherapy
