Ovarian cancer medical therapy: Difference between revisions
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==MedicalTherapy== | ==MedicalTherapy== | ||
* Epithelial ovarian cancer includes ovarian, fallopian tube, and peritoneal cancer and the combination of the three is referred to as (EOC) due to the similarity in their clinical behavior and characteristics | |||
*Epithelial ovarian cancer includes ovarian, fallopian tube, and peritoneal cancer and the combination of the three is referred to as (EOC) due to the similarity in their clinical behavior and characteristics | *EOC is usually diagnosed in its late stages due to its subclinical or nonspecific symptoms | ||
*The mainstay of definitive diagnosis and initial management of ovarian cancer is surgical operation to determine if it is benign or malignant, determine its stage and grade, and then treat it accordingly | *The mainstay of definitive diagnosis and initial management of ovarian cancer is surgical operation to determine if it is benign or malignant, determine its stage and grade, and then treat it accordingly | ||
*The medical management of ovarian cancer is usually done as an adjuvant to the surgical therapy | *The medical management of ovarian cancer is usually done as an adjuvant to the surgical therapy | ||
*Based on the surgical staging and grading of the tumor the management can be one of the following: | *Based on the surgical staging and grading of the tumor the management can be one of the following: | ||
** Early stage EOC | |||
*** Stage IA or IB | |||
**** No high risk features | |||
***** No need to use adjuvant chemotherapy | |||
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Revision as of 15:10, 11 July 2019
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Ovarian cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Ovarian cancer medical therapy On the Web |
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American Roentgen Ray Society Images of Ovarian cancer medical therapy |
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Risk calculators and risk factors for Ovarian cancer medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical therapies, such as chemotherapy and radiation, are often employed post-surgerical therapy as a means to treat residual disease. The success of medical therapy often hinges on the histology of the tumor.
MedicalTherapy
- Epithelial ovarian cancer includes ovarian, fallopian tube, and peritoneal cancer and the combination of the three is referred to as (EOC) due to the similarity in their clinical behavior and characteristics
- EOC is usually diagnosed in its late stages due to its subclinical or nonspecific symptoms
- The mainstay of definitive diagnosis and initial management of ovarian cancer is surgical operation to determine if it is benign or malignant, determine its stage and grade, and then treat it accordingly
- The medical management of ovarian cancer is usually done as an adjuvant to the surgical therapy
- Based on the surgical staging and grading of the tumor the management can be one of the following:
- Early stage EOC
- Stage IA or IB
- No high risk features
- No need to use adjuvant chemotherapy
- No high risk features
- Stage IA or IB
- Early stage EOC
- Chemotherapy is used after surgery to treat any residual disease, if appropriate. This depends on the histology of the tumor; some kinds of tumor (particularly teratoma) are not sensitive to chemotherapy. In some cases, there may be reason to perform chemotherapy first, followed by surgery.
- Many oncologists recommend intravenous (IV) chemotherapy including a platinum drug with a taxane as a preferred method of treating advanced ovarian cancer. However, three recent randomized studies clinical trials suggest that chemotherapy that is partly IV and partly via direct infusion into the abdominal cavity (intraperitoneal or IP) may improve median survival time.
- IP chemotherapy generally has higher toxicity and its advantages are still debated among specialists.
- Currently for Stage IIIC ovarian adenocarcinomas after optimal debulking, median time for survival is statistically significantly longer for patient receiving intraperitoneal chemotherapy.
- Patients in this clinical trial did report less compliance with IP chemotherapy, and fewer than half of the patients received all six cycles of IP chemotherapy.
- Despite this high "drop-out" rate, the group as a whole (including the patients that didn't complete IP chemotherapy treatment) survived longer on average than patients who received intravenous chemotherapy alone. These results can be interpreted in couple of ways. One could argue if the IP chemotherapy treatment group had completed the six cycles of chemotherapy their lives would have been prolonged even longer. Or the advantages of receiving IP chemotherapy are significant in the early phases of chemotherapy. Some specialists believe the IP chemotherapy toxicities will be unnecessary with improved IV chemotherapy drugs currently being developed.
- Radiation therapy is not effective for advanced stages because when vital organs are in the radiation field, a high dose cannot be safely delivered.