Professor Yang Jiaxin | Correct assessment diagnosis is guaranteed, standardized diagnosis and treatment is the key!2022-01-19 12:06:01 47 ℃
Gynecological tumors are a common type of disease in gynecological diseases. At present, the treatment means for gynecological tumors is mainly surgical, chemotherapy, radiotherapy and targeted treatment. With the continuous in-depth, new effective strategies and patterns of tumor understanding and research, the medical diagnosis and treatment will gradually improve the efficacy of patients, improve the patient's quality of life. The Chinese Obstetrics and Gynecology Network specially invited Yang Jiaxin, Beijing Association, exchanges and discusses the diagnosis and treatment of malignant tumors such as ovarian cancer, ovarian ovarooma.
Comprehensive treatment of surgery + chemotherapy + maintenance treatment
Epithel ovarian cancer is also known as silent killer. Although the incidence of epithelial ovarian cancer in three major malignant tumors is not the highest, the mortality has always been high, because there is no effective means and early diagnosis methods that have no ovarian cancer screening.
The treatment of advanced ovarian cancer has two 70% -80%, namely 70% -80% of patients with ovarian cancer. It is already late, 70% -80% of patients with advanced ovarian cancer will be recurred within 3 years, so we It can be seen that no matter how foreign gynecological tumor conferences, nearly half of the research is about ovarian cancer.
Rest research hotspots in recent years is a targeted therapy -PARP inhibitor that everyone is familiar. PARP inhibitors have changed some changes in the treatment model of advanced ovarian cancer. The treatment of advanced ovarian cancer is mainly surgical + chemotherapy two swords, and the proportion is 50%. The current treatment is added to maintain treatment, so the treatment of advanced ovarian cancer has three parts: surgery + chemotherapy + maintenance treatment. In the past decade, PARP inhibitors have been hot in advanced ovarian cancer maintenance.
Maintenance treatment refers to the state of maintaining tumor clinical relief, the longer the time. Therefore, gynecological tumors should clearly understand the treatment of cornerstone in advanced ovarian cancer is surgical + chemotherapy. Only very good surgery and chemotherapy have reached clinical relief to begin access to maintenance treatment, and start oral maintenance of drugs extend tumor-survival time. Upper skin ovarian cancer gene detection can predict which type of patient is longer longer? In addition to surgery, patients with chemotherapy, patients with BRCA gene mutation or homologous recombinant defect HRD maintain the treatment.
In the past five years, the clinical study of the global multi-center III period in advanced epithelial ovarian cancer is maintained. The results show that the patient's ratio of PARP inhibitors is taken for the first-line maintenance of the ovarian cancer of platinum-sensitive recurrence or for advanced ovarian cancer Patients who are unattended can extend the tumor survival of one year or even longer. From then on, the surgery of advanced epithelial ovarian cancer is opened + chemotherapy + maintenance treatment of three means, and manages advanced ovarian cancer patients.
Correct assessment is guaranteed
Generally, the epithelial ovarian cancer is already late, only small partial epithelial ovarian cancer is in early tumor state during discovery. Whether to retain fertility, the decisive factor is the state of the tumor. In other words, the tumors of patients suffering from patients are early tumors. The tumor cell type is not high, and it can survive for a long time. This is a female doctor to take treatment for fertility. Determining the tumor is the key to the problem of the tumor cells. It takes imaging examination, including PET-CT and other inspection methods. Early tumors, experienced pathogenesis clarified the pathological type, such patients can accept early epithelial ovarian cancer The treatment of birth function is not complex, and the early tumor is limited to one side of ovaries, and comprehensive installment surgery for retaining side normal accessories and uterus.
Give exert the advantages of regional clinics
Standardize the treatment of ovarian malignant reproductive cells
In recent months, Beijing Union Hospital has accumulated a wealth of clinical experience in the diagnosis and treatment of gynecological malignant germ cell tumors. Ovarian malignant reproductive cell tumors are good to young people, and domestic and foreign reports have between the ages of 17-22, which is the first to explore the beginning of gynecological malignant tumor retention. Older generations of women's tumor experts like Langjing and Academician, Professor Wu Hao did the treatment of maternal reproductive cell tumor retention.
Ovarian ovarioma is a relatively rare type. Most gynecological tumors lack experience in this regard, and therefore, in particular, the treatment of such tumors should be regulated in the large diagnosis and treatment. Through normalized treatment, about 90% of patients can cure, so standardized treatment is especially important for such patients. It is also because of the treatment effect, the cure rate can reach 90%, and relatively small in the new drug research and development, most emphasis is more emphasized, emphasizing the cure.
In recent years, the Department of Concorders is a national gynecology disease-difficult case center and the intensive, recurred, uncontrolled malignant reproductive cell tumor, which has also made some particularly detailed, related basic research. , Including yolk saculation. We perform exon sequencing in such tumors, the analysis of all genetic biological information, has been recognized by foreign academics, in order to better standardize the treatment of rare gynecological malignant tumors, promote the treatment advantages of regional large comprehensive centers, This part of the young patient can reach the cure and reach long-term survival. It is true that most drug-resistant patients is still in the early treatment of irregularity or in the initial treatment, especially the ovarogenic sacral tumor, once ruptures, the growth is very rapid, many doctors may not know that this disease is rapid and delayed initial Diagnose treatment.
The gynecological tumor field will hear more the development of medical treatment of Chinese doctors, whether it is early diagnosis, screening prevention, drug treatment and all disease diagnosis, depending on scientific progress. The advancement of medicine depends on the progress of natural science, such as better imaging methods, better hematology testing, genetic analysis, etc. For gynecological malignant tumors, some tumors have been made in prevention. For example, we already have the HPV vaccine to prevent cervical cancer, there is already a screening method of cervical cancer. For treatable epithelial ovarian cancer, we also want to seek some early screening, early diagnosis methods, which is also the direction of future gynecological tumors research - early diagnosis, early treatment, screening and prevention.
In addition, in terms of gynecological malignant tumors, you will think of there is no new surgical technology, new drugs. Scientific technology will demonstrate advances to the diagnosis, but each technology, method, drug should be applied to the human body. First of all, the most important thing is to meet medical ethics, and there is a need to have evidence. In many cancer, our country is like a world leader in the diagnosis of liver cancer. Which drug is good, which treatment is more effective, and there is a clinical study of RCT. The gynecological malignant tumor is also the same, with clinical research data to prove which drug is effective, which drug is ineffective. China has the number of patients around the world. We must issue the voices of Chinese gynecological tumor diagnosis and treatment. Data should be used. Currently strengthen horizontal cooperation, digital management will certainly accelerate the clinical study of gynecological tumors. In terms of academic exchanges in the field of gynecological tumors, there must be a clinical study of Chinese gynecological tumors in diagnosis and treatment to international peers.
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