邱彩虹;邱丽华;

• 1:上海交通大学医学院附属仁济医院妇产科

摘要(Abstract)：

卵巢癌是妇科肿瘤中死亡率居首位的肿瘤,传统的治疗方法为肿瘤细胞减灭术的基础上联合药物(铂类和紫杉醇为主的)化疗,近年治疗方法的进步使越来越多的患者得到完全缓解,但最终大多患者会复发。复发后存活时间一般少于3年。复发性卵巢癌主要的治疗方法仍是化疗(铂敏感型仍采用铂类为基础的化疗,铂耐药型则多认为使用非铂类药物)和手术(二次肿瘤细胞减灭术)。以肿瘤发病机制为基础的靶向治疗方法近年成为研究热点,进一步研究基因和信号转导途径将为治疗该病提供新途径。现就近年各种治疗方法的有效性和安全性做一综述。

关键词(KeyWords)： 复发性卵巢癌;二次肿瘤细胞减灭术;化学疗法;免疫治疗;分子靶向治疗

Abstract:

Keywords:

基金项目(Foundation): 上海市教委重点学科项目;; 上海市妇科肿瘤重点实验室项目

作者(Authors): 邱彩虹;邱丽华;

DOI: 10.13283/j.cnki.xdfckjz.2012.01.020

参考文献(References)：

• [1]沈铿.复发性卵巢癌的诊断和治疗策略[J].现代妇产科进展,2005,14(3):177-180
• [2]Rustin GJ,vander Burg ME,Griffin CL,et al.Early versusdelayed treatment of relapsed ovarian cancer(MRCOV05/EORTC 55955):a randomised trial.[J]Lancet,2010,376(9747):1155-1163
• [3]Fleming ND,Cass I,Walsh CS,et al.CA125 surveillanceincreases optimal resectability at secondary cytoreductivesurgery for recurrent epithelial ovarian cancer[J].GynecolOncol,2011,121(2):249-252
• [4]Galaal K,Naik R,Bristow RE,et al.Cytoreductive surgeryplus chemotherapy versus chemotherapy alone for recur-rent epithelial ovarian cancer[J].Cochrane Database SystRev,2010,16(6):CD007822
• [5]Chi DS,McCaughty K,Diaz JP,et al.Guidelines and se-lection criteria for secondary cytoreductive surgery in pa-tients with recurrent,platinum-sensitive epithelial ovariancarcinoma[J].Cancer,2006,106(9):1933-1939
• [6]Alberts DS,Liu PY,Wilczynski SP,et al.Randomized trialof pegylated liposomal doxorubicin(PLD)plus carbopla-tin versus carboplatin in platinum-sensitive(PS)patientswith recurrent epithelial ovarian or peritoneal carcinomaafter failure of initial platinum-based chemotherapy(Southwest Oncology Group Protocol S0200)[J].GynecolOncol,2008,108(1):90-94
• [7]Bookman MA,Brady MF,McGuire WP,et al.Evaluation ofnew platinum-based treatment regimens in advanced-stageovarian cancer:a phaseⅢtrial of the Gynecologic CancerIntergroup[J].J Clin Oncol,2009,27:1419-1425
• [8]Verhaar-Langereis M,Karakus A,Van Eijkeren M,et al.PhaseⅡstudy of the combination of pegylated liposomaldoxorubicin and topotecan in platinum-resistant ovariancancer[J].Inter J Gynecol Cancer,2006,16(1):65-70
• [9]Leffers N,Daemen T,Helfrich W,et al.Antigen-specificactive immunotherapy for ovarian cancer[J].CochraneDatabase Syst Rev,2010,(1):CD007287
• [10]Leffers N,Vermeij R,Hoogeboom BN,et al.Long-termclinical and immunological effects of p53-SLP vaccine inpatients with ovarian cancer[J].Int J Cancer,2011,doi:10.1002/ijc.25980
• [11]Leffers N,Lambeck AJ,Gooden MJ,et al.Immunizationwith a P53 synthetic long peptide vaccine induces P53-specific immune responses in ovarian cancer patients,aphaseⅡtrial[J].Int J Cancer,2009,125(9):2104-2113
• [12]TobiásováZ,PospísilováD,Miller AM,et al.In vitro as-sessment of dendritic cells pulsed with apoptotic tumorcells as a vaccine for ovarian cancer patients[J].ClinImmunol,2007,122(1):18-27
• [13]Teoh DG,Secord AA.Antiangiogenic therapies in epithe-lial ovarian cancer[J].Cancer Control,2011,18(1):31-43
• [14]Cannistra SA,Matulonis UA,Penson RT,et al.PhaseⅡstudy of bevacizumab in patients with platinum-resistantovarian cancer or peritoneal serous cancer[J].J Clin On-col,2007,25(33):5180-5186
• [15]Sfakianos GP,Numnum TM,Halverson CB,et al.Therisk of gastrointestinal perforation and/or fistula in pa-tients with recurrent ovarian cancer receiving bevacizum-ab compared to standard chemotherapy:a retrospectivecohort study[J].Gynecol Oncol,2009,114(3):424-426
• [16]Garcia AA,Hirte H,Fleming G,et al.PhaseⅡclinicaltrial of bevacizumab and low-dose metronomic oral cyclo-phosphamide in recurrent ovarian cancer:a trial of theCalifornia,Chicago,and Princess Margaret Hospital phaseⅡconsortia[J].J Clin Oncol,2008,26(1):76-82
• [17]Hirte HW,Vidal L,Fleming GF,et al.A phaseⅡstudyof cediranib(AZD2171)in recurrent or persistent ovari-an,peritoneal or fallopian tube cancer.Final results of aPMH,Chicago and California consortia trial[J].J ClinOncol,2008,26:298S
• [18]Matulonis UA,Berlin S,Ivy P,et al.Cediranib,an oralinhibitor of vascular endothelial growth factor receptor ki-nases,is an active drug in recurrent epithelial ovarian,fallopian tube,and peritoneal cancer[J].J Clin Oncol,2009,27(33):5601-5606
• [19]Schilder RJ,Pathak HB,Lokshin AE,et al.PhaseⅡtrialof single agent cetuximab in patients with persistent orrecurrent epithelial ovarian or primary peritoneal carcino-ma with the potential for dose escalation to rash[J].Gy-necol Oncol,2009,113(1):21-27
• [20]Vasey PA,Gore M,Wilson R,et al.A phase Ib trial ofdocetaxel,carboplatin and erlotinib in ovarian,fallopiantube and primary peritoneal cancers[J].Br J Cancer,2008,98(11):1774-1780
• [21]Nimeiri HS,Oza AM,Morgan RJ,et al.Eficacy and safe-ty of bevacizumab plus erlotinib for patients with recur-rent ovarian,primary peritoneal,and fallopian tube canc-er:a trial of the Chicago,PMH,and California Phase 1IConsortia[J].Gynecol Oncol,2008,110(1):49-55
• [22]Miller DS,Blessing JA,Krasner CN,et al.PhaseⅡeval-uation of pemetrexed in the treatment of recurrent or per-sistent platinum-resistant ovarian or primary peritonealcarcinoma:a study of the Gynecologic Oncology Group[J].J Clin Oncol,2009,27(16):2686-2691