切换至 "中华医学电子期刊资源库"
高级检索
中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2020, Vol. 16 ›› Issue (01) : 16 -22. doi: 10.3877/cma.j.issn.1673-5250.2020.01.003

所属专题： 文献；

述评

早期上皮性卵巢癌化学治疗现状与思考
龚照林1, 李克敏1, 尹如铁1,†()   
  1. 1. 四川大学华西第二医院妇产科、出生缺陷与相关妇儿疾病教育部重点实验室，成都　610041
  • 收稿日期:2019-12-01 修回日期:2020-01-11 出版日期:2020-02-01
  • 通信作者: 尹如铁

Current chemotherapy research status and consideration of early-stage epithelial ovarian cancer

Zhaolin Gong1, Kemin Li1, Rutie Yin1,†()   

  1. 1. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2019-12-01 Revised:2020-01-11 Published:2020-02-01
  • Corresponding author: Rutie Yin
  • About author:
    Corresponding author: Yin Rutie, Email:
  • Supported by:
    Science and Technology Plan Project of Science and Technology Department of Sichuan Province(19ZDYF2754)
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

龚照林, 李克敏, 尹如铁. 早期上皮性卵巢癌化学治疗现状与思考[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(01): 16-22.

Zhaolin Gong, Kemin Li, Rutie Yin. Current chemotherapy research status and consideration of early-stage epithelial ovarian cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2020, 16(01): 16-22.

目前卵巢癌患者的死亡率，高居女性生殖系统恶性肿瘤患者的首位。卵巢癌的组织病理学类型复杂，其中上皮性卵巢癌(EOC)最为常见。但是，临床诊断的早期上皮性卵巢癌(EEOC)患者，仅占全部被诊断卵巢癌患者的30%。全面分期手术后，对高危EEOC患者的辅助化疗，是EEOC患者的标准治疗策略，但是辅助化疗方面，迄今尚有很多值得探讨的问题。笔者拟就EEOC患者术后辅助化疗研究现状，如患者化疗获益、化疗方案和化疗最佳时机选择、化疗疗程与淋巴切除问题的研究现状进行阐述，旨在为本病的规范化临床治疗提供参考。

关键词: 卵巢肿瘤, 上皮样细胞, 癌，子宫内膜样, 上皮性卵巢肿瘤，早期, 腺癌，透明细胞, 抗肿瘤联合化疗方案, 女(雌)性

Ovarian cancer is one of the most deadly malignancies of female reproductive system, with complex pathological types. The epithelial ovarian cancer (EOC) is the most common pathological type in ovarian cancer, but early-stage epithelial ovarian cancer (EEOC) only accounts for 30% in all diagnosed ovarian cancer. Adjuvant chemotherapy is the standard treatment strategy for high-risk EEOC patients after comprehensive staging surgery, but many issues are still worthy of discussion in adjuvant chemotherapy. We intend to clarify the current research status of postoperative adjuvant chemotherapy in patients with EEOC, such as the benefits of chemotherapy, the choice of chemotherapy regimen and the best timing for chemotherapy, the duration of chemotherapy and lymphadenectomy. We expect that this review can help providing references for standardized treatment of this disease.

Key words: Ovarian neoplasms, Epithelioid cells, Carcinoma, endometrioid, Epithelial ovarian neoplasms, early stage, Adenocarcinoma, clear cell, Antineoplastic combined chemotherapy protocols, Female
[1]
De Vita V, Hellman S, Rosenberg SA. Cancer: principles and practice of oncology[J]. J Am Med Association, 2001, 286: 1904-1905. DOI: 10.1001/jama.286.15.1904.
[2]
Young RC, Walton LA, Ellenberg SS, et al. Adjuvant therapy in stageⅠ and stage Ⅱ epithelial ovarian cancer results of two prospective randomized trials[J]. NEJM, 1990, 322(15): 1021-1027. DOI: 10.1056/NEJM199004123221501.
[3]
Chan JK, Tian C, Monk BJ, et al. Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study[J]. Cancer, 2008, 112(10): 2202-2210. DOI: 10.1002/cncr.23390.
[4]
Colombo N, Guthrie D, Chiari S, et al. International Collaborative Ovarian Neoplasm trial 1: a randomized trial of adjuvant chemotherapy in women with early-stage ovarian cancer[J]. J Natl Cancer Inst, 2003, 95(2): 125-132. DOI: 10.1093/jnci/95.2.125.
[5]
Trimbos JB, Vergote I, Bolis G, et al. Impact of adjuvant chemotherapy and surgical staging in early-stage ovarian carcinoma: European Organisation for Research and Treatment of Cancer-Adjuvant ChemoTherapy in Ovarian Neoplasm trial[J]. J Natl Cancer Inst, 2003, 95(2): 113-125. DOI: 10.1093/jnci/95.2.113.
[6]
Lawrie TA, Winter-Roach BA, Heus P, et al. Adjuvant (post-surgery) chemotherapy for early stage epithelial ovarian cancer[J]. Cochrane Database Syst Rev, 2015, (12): CD004706. DOI: 10.1002/14651858.CD004706.pub5.
[7]
Trimbos JB, Parmar M, Vergote I, et al. International Collaborative Ovarian Neoplasm trial 1 and Adjuvant ChemoTherapy In Ovarian Neoplasm trial: two parallel randomized phase Ⅲ trials of adjuvant chemotherapy in patients with early-stage ovarian carcinoma[J]. J Natl Cancer Inst, 2003, 95(2): 105-112. DOI：10.1093/jnci/95.2.105.
[8]
Tropé C, Kaern J, Hogberg T, et al. Randomized study on adjuvant chemotherapy in stage Ⅰhigh-risk ovarian cancer with evaluation of DNA-ploidy as prognostic instrument[J]. Ann Oncol, 2000, 11(3): 281-288. DOI: 10.1023/a：1008399414923.
[9]
Bolis G, Colombo N, Pecorelli S, et al. Adjuvant treatment for early epithelial ovarian cancer: results of two randomised clinical trials comparing cisplatin to no further treatment or chromic phosphate (32P)[J]. Ann Oncol, 1995, 6(9): 887-893. DOI: 10.1093/oxfordjournals.annonc.a059355.
[10]
Collinson F, Qian W, Fossati R, et al. Optimal treatment of early-stage ovarian cancer[J]. Ann Oncol, 2014, 25(6): 1165-1171. DOI: 10.1093/annonc/mdu116.
[11]
Adams G, Zekri J, Wong H, et al. Platinum-based adjuvant chemotherapy for early-stage epithelial ovarian cancer: single or combination chemotherapy？[J]. BJOG, 2010, 117(12): 1459-1467. DOI: 10.1111/j.1471-0528.2010.02635.x.
[12]
Kolb BA, Buller RE, Connor JP, et al. Effects of early postoperative chemotherapy on wound healing[J]. Obstet Gynecol, 1992, 79(6): 988-992.
[13]
Wright J, Doan T, McBride R, et al. Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival[J]. Br J Cancer, 2008, 98(7): 1197-1203. DOI: 10.1038/sj.bjc.6604298.
[14]
Tewari KS, Java JJ, Eskander RN, et al. Early initiation of chemotherapy following complete resection of advanced ovarian cancer associated with improved survival: NRG Oncology/Gynecologic Oncology Group study[J]. Ann Oncol, 2016, 27(1): 114-121. DOI: 10.1093/annonc/mdv500.
[15]
Dinkelspiel HE, Tergas AI, Zimmerman LA, et al. Use and duration of chemotherapy and its impact on survival in early-stage ovarian cancer[J]. Gynecol Oncol, 2015, 137(2): 203-209. DOI: 10.1016/j.ygyno.2015.02.013.
[16]
Chatterjee S, Chen L, Tergas AI, et al. Utilization and outcomes of chemotherapy in women with intermediate-risk, early-stage ovarian cancer[J]. Obste Gynecol, 2016, 127(6): 992-1002. DOI: 10.1097/AOG.0000000000001404.
[17]
Winter-Roach BA, Kitchener HC, Lawrie TA. Adjuvant (post-surgery) chemotherapy for early stage epithelial ovarian cancer[J]. Cochrane Database Syst Rev, 2012, (3): CD004706. DOI: 10.1002/14651858.CD004706.pub4.
[18]
Hogen L, Brar H, Covens A, et al. Is adjuvant chemotherapy beneficial for surgical stage Ⅰ ovarian clear cell carcinoma？[J]. Gynecol Oncol, 2017, 147(1): 54-60. DOI: 10.1016/j.ygyno.2017.07.128.
[19]
Takada T, Iwase H, Iitsuka C, et al. Adjuvant chemotherapy for stage Ⅰ clear cell carcinoma of the ovary an analysis of fully staged patients[J]. Int J Gynecol Cancer, 2012, 22(4): 573-578. DOI: 10.1097/IGC.0b013e31823fd413.
[20]
Mizuno M, Kajiyama H, Shibata K, et al. Adjuvant chemotherapy for stage Ⅰ ovarian clear cell carcinoma is it necessary for stage ⅠA？[J]. Int J Gynecol Cancer, 2012, 22(7): 1143-1149. DOI: 10.1097/IGC.0b013e31825c7cbe.
[21]
Oseledchyk A, Leitao MM Jr, Konner J, et al. Adjuvant chemotherapy in patients with stage Ⅰ endometrioid or clear cell ovarian cancer in the platinum era: a surveillance, epidemiology, and end results cohort study, 2000-2013[J]. Ann Oncol，2017, 28(12): 2985-2993. DOI: 10.1093/annonc/mdx525.
[22]
Timmers PJ, Zwinderman AH, Teodorovic I, et al. Clear cell carcinoma compared to serous carcinoma in early ovarian cancer: same prognosis in a large randomized trial[J]. Int J Gynecol Cancer, 2009, 19(1): 88-93. DOI: 10.1111/IGC.0b013e3181991546.
[23]
Nasioudis D, Haggerty AF, Giuntoli RL, et al. Adjuvant chemotherapy is not associated with a survival benefit for patients with early stage mucinous ovarian carcinoma[J]. Gynecol Oncol, 2019, 154(2): 302-307. DOI: 10.1016/j.ygyno.2019.05.009.
[24]
Chan JK, Java JJ, Fuh K, et al. The association between timing of initiation of adjuvant therapy and the survival of early stage ovarian cancer patients: an analysis of NRG Oncology/Gynecologic Oncology Group trials[J]. Gynecol Oncol, 2016, 143(3): 490-495. DOI: 10.1016/j.ygyno.2016.09.015.
[25]
Young RC, Brady MF, Nieberg RK, et al. Adjuvant treatment for early ovarian cancer: a randomized phase Ⅲ trial of intraperitoneal 32P or intravenous cyclophosphamide and cisplatin--a gynecologic oncology group study[J]. J Clin Oncol, 2003, 21(23): 4350-4355. DOI: 10.1200/JCO.2003.02.154.
[26]
Bell J, Brady MF, Young RC, et al. Randomized phase Ⅲ trial of three versus six cycles of adjuvant carboplatin and paclitaxel in early stage epithelial ovarian carcinoma: a Gynecologic Oncology Group study[J]. Gynecol Oncol, 2006, 102(3): 432-439. DOI: 10.1016/j.ygyno.2006.06.013.
[27]
Chan JK, Tian C, Fleming GF, et al. The potential benefit of 6 vs 3 cycles of chemotherapy in subsets of women with early-stage high-risk epithelial ovarian cancer: an exploratory analysis of a Gynecologic Oncology Group study[J]. Gynecol Oncol, 2010, 116(3): 301-306. DOI: 10.1016/j.ygyno.2009.10.073.
[28]
FIGO Committee on Gynecologic Oncology, Prat J. FIGO′s staging classification for cancer of the ovary, fallopian tube, and peritoneum: abridged republication[J]. J Gynecol Oncol, 2015, 26(2): 87-89. DOI: 10.3802/jgo.2015.26.2.87.
[29]
Deborah K, Ronald D, Jamie N, et al. Ovarian cancer including fallopian tube cancer and primary peritoneal cancer (version 3. 2019)[EB/OL]. (2019-11-26) [2020-01-04].

URL    
[30]
Kleppe M, van der Aa MA, Van Gorp T, et al. The impact of lymph node dissection and adjuvant chemotherapy on survival: a nationwide cohort study of patients with clinical early-stage ovarian cancer[J]. Eur J Cancer, 2016, 66: 83-90. DOI: 10.1016/j.ejca.2016.07.015.
[31]
Matulonis UA, Sood AK, Fallowfield L, et al. Ovarian cancer[J]. Nat Rev Dis Primers, 2016, 2: 16061. DOI: 10.1038/nrdp.2016.61.
[32]
Desantis CE, Siegel RL, Sauer AG, et al. Cancer statistics for African Americans, 2016: progress and opportunities in reducing racial disparities[J]. CA Cancer J Clin, 2016, 66(4): 290-308. DOI: 10.3322/caac.21340.
[33]
Zsiros E, Tanyi J, Balint K, et al. Immunotherapy for ovarian cancer: recent advances and perspectives[J]. Curr Opin Oncol, 2014, 26(5): 492-500. DOI: 10.1097/CCO.0000000000000111，PMID: 25036883.
[34]
唐英，李均，徐凡，等. 单核细胞与淋巴细胞比值及其与上皮性卵巢癌患者预后的关系 [J/CD] . 中华妇幼临床医学杂志(电子版)，2017，13(5): 532-538. DOI: 10.3877/cma.j.issn.1673-5250.2017.05.006.
[1] 顾娟, 孙擎擎, 胡方方, 曹义娟, 祁玉娟. 子宫内膜容受性检测改善胚胎反复种植失败患者妊娠结局的临床应用[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 582-587.
[2] 林昌盛, 战军, 肖雪. 上皮性卵巢癌患者诊疗中基因检测及分子靶向药物治疗[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 505-510.
[3] 马敏榕, 李聪, 周勤. 宫颈癌治疗研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 497-504.
[4] 周东杰, 蒋敏, 范海瑞, 高玲玲, 孔祥, 卢丹, 王丽萍. 非编码RNA在卵泡发育成熟中作用及其机制的研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 387-393.
[5] 陈荟竹, 郭应坤, 汪昕蓉, 宁刚, 陈锡建. 上皮性卵巢癌"二元论模型"的分子生物学研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 394-402.
[6] 韩春颖, 王婷婷, 李艳艳, 朴金霞. 子宫内膜癌患者淋巴管间隙浸润预测因素研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 403-409.
[7] 刘星辰, 刘娟, 魏宝宝, 刘洁, 刘辉. XIAP与XAF1异常表达与卵巢癌的相关性分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 419-427.
[8] 魏权, 张燊, 陈慧佳, 邹姮, 胡丽娜. 女性生殖道微生物群与辅助生殖技术相关性研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 151-155.
[9] 刘艳艳, 谭曦, 彭雪. 妊娠合并膀胱低度恶性潜能乳头状尿路上皮肿瘤并文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 212-218.
[10] 胡欧婵, 黄仲英. 不明原因复发性流产患者的治疗研究现状与展望[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 16-22.
[11] 戴佑任, 张悦, 李扬, 王聪, 陈婷, 程文俊, 罗成燕. 未分化/去分化子宫内膜癌的临床病理学特征及治疗研究[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 660-668.
[12] 张晓芳, 王平. 阴道黑色素瘤诊疗研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 621-626.
[13] 尤琳, 蔡振伟, 乔荆. Turner综合征临床研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 634-639.
[14] 刘育昕, 王子晗, 张艺馨, 栾永婕, 孟凯. 肾母细胞瘤基因1在卵巢疾病发病机制中的研究进展[J]. 中华诊断学电子杂志, 2023, 11(03): 178-183.
[15] 王可珺, 李吉镇, 马标, 续慧超, 谌红珊, 刘雷. 肌酐/胱抑素C对晚期上皮性卵巢癌术后并发症的预测价值[J]. 中华诊断学电子杂志, 2023, 11(01): 49-55.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号