摘要
晚期上皮性卵巢癌(epithelial ovarian cancer, EOC)是常见的女性生殖系统恶性肿瘤,因死亡率高而臭名远扬。我国及国际指南推荐的晚期上皮性卵巢癌治疗标准是初始肿瘤细胞减灭术(primary debulking surgery, PDS)后辅以化疗。由于部分晚期上皮性卵巢癌患者初诊时伴随内科合并症多且严重、肿瘤负荷大、瘤体累及范围大等情况,导致PDS无法达到满意的减瘤效果或无法行手术治疗。迄今为止,许多研究结果表明新辅助化疗(neoadjuvant chemotherapy, NACT)后行间歇性肿瘤减灭术(internal debulking surgery, IDS)的生存结局不亚于PDS联合含铂化疗。因此,NACT-IDS可能是晚期EOC的一种替代治疗方案。随着NACT在晚期上皮性卵巢癌治疗应用,新辅助化疗的疗效及适应证成为了妇科肿瘤学家争论的热门话题。本文旨在探讨新辅助化疗治疗晚期上皮性卵巢癌的现状,并进一步探讨NACT的疗效及适应症。
Advanced epithelial ovarian cancer is a common malignant tumor of the female reproductive sys-tem and is notorious for its high mortality rate. The standard of treatment for advanced epithelial ovarian cancer recommended by our national and international guidelines is primary debulking surgery (PDS) followed by chemotherapy. As some patients with advanced epithelial ovarian cancer are accompanied by many serious medical comorbidities, large tumor load, and extensive tumor involvement at the time of initial diagnosis, PDS fails to achieve a satisfactory tumor reduction effect or prevents surgical treatment. Many findings to date have demonstrated that neoadjuvant chem-otherapy (NACT) followed by internal debulking surgery (IDS) has a survival outcome no less fa-vorable than PDS combined with platinum-containing chemotherapy. Thus, NACT-IDS is probably an alternative treatment option for advanced EOC. With the therapeutic application of NACT in the treatment of advanced epithelial ovarian cancer, the efficacy and indications for neoadjuvant chemotherapy have become a hot topic of debate among gynecologic oncologists. The purpose of this article is to discuss the current status of neoadjuvant chemotherapy for advanced epithelial ovarian cancer and to discuss further the efficacy and indications for NACT.
出处
《临床医学进展》
2024年第1期2236-2243,共8页
Advances in Clinical Medicine
