doi:10.7504/fk2015020103

Abstract

Key words: resistance, recurrence, gynecologic malignant tumor

摘要：

妇科恶性肿瘤发生于女性生殖系统，最常见的有子宫颈癌、卵巢癌、子宫内膜癌、滋养细胞肿瘤等。其中上皮性卵巢癌耐药及复发的发生率最高，尽管手术理念不断更新和手术技巧不断改进，晚期上皮性卵巢癌满意的初次手术率除个别报道可达90％外，大多报道在3.9%~62.9％，不满意的初次手术为耐药及复发埋下了隐患。另一方面，随着新的化疗药物和方案的不断出现和更新，初次化疗的缓解率有所提高，但大多数晚期病例在完全缓解后2年左右复发，复发率高达80％。子宫颈癌的复发主要与期别相关，ⅠB期约10％，ⅡA期约17％，ⅡB期为23％，Ⅲ期和Ⅳ期分别达42%和74%；此外还与肿瘤大小有关，原发灶直径≤2 cm者仅1.2％，而>2 cm者高达21% 。子宫内膜癌进展比较缓慢，出现症状时大多为早期，手术或联合放疗或放化疗通常有效，总体复发率较低，仅13％左右。滋养细胞肿瘤对化疗高度敏感，是预后最好的实体瘤之一，低危病例治愈率达100％，耐药及复发仅发生于高危病例，约20％左右。尽管各种妇科恶性肿瘤耐药及复发率不尽相同，但总体发生率与其他系统肿瘤相当，临床上应予足够的重视。

关键词: 耐药, 复发, 妇科恶性肿瘤

CLC Number:

Ｒ737.3

王新宇，谢幸. 复发性耐药性妇科恶性肿瘤治疗策略[J]. 中国实用妇科与产科杂志, DOI: 10.7504/fk2015020103.

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（2014-11-14收稿）

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复发性耐药性妇科恶性肿瘤治疗策略

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