OVARIAN CANCER

Most of the malignant ovarian tumors, radiation therapy for various effects are poor. Therefore, in the treatment of malignant ovarian tumor was not first consider radiotherapy. After laparotomy confirmed to be malignant ovarian tumor resection not all, in vitro viable X-ray irradiation. But many of ascites are not OK radiotherapy; The abdominal tumor metastasis to the effect of not limited to those within the pelvic cavity. X-ray irradiation is also used in vitro malignant ovarian tumor before and after surgery. Preoperative radiotherapy for patients with radiation therapy after the word four to six weeks should surgery again night, while radiation caused by adhesions, surgery often caused difficulties. Surgery will be in regular radiation treatment after two weeks before and after the start, such as whole body ill patients should first correct.
(1), abdominal irradiation radiation field including full pots of abdominal viscera, or by Ono divided into two to four vertical irradiation of Ono, tumor dose of 25 Gy ~ / 6 to 8 weeks. General liver, kidney tolerance were 30 Gy and 18 Gy, such as the super-dose, should shielding protection. Whole abdominal irradiation after Ono, the largest general tolerance of 30 Gy / 6 to 7 weeks. This dose is not LD50 of ovarian cancer, while Ono irradiation reaction, difficult patient tolerance. Delcios in 1963, a fully mobile strip abdominal irradiation in the treatment of ovarian cancer. Each abdominal irradiation of 10 cm, radiation field from the upward movement in the entire basin to include abdominal, each irradiation in 12 days. Tumor radiation dose of 26 to 28 Gy. The biological effects of radiation and improve the patient's response to radiotherapy.
(2), pelvic tumor irradiation dose of 40 to 60 Gy, 6 to 8 weeks to complete.
(3), plus whole abdominal pelvic irradiation Ono whole abdominal irradiation may be, or transfer surgery strip irradiation dose with the former. Pelvic organ tolerance, to improve efficacy, and pelvic irradiation dose of 20 to 30 Gy, ovarian cancer is the commonly used method.
(4), abdominal radionuclide therapy for patients early preventive treatment, and only a small residual tumor after treatment. Surgery not cut net of malignant ovarian tumor metastases can be injected with the radioactive colloid 98 or 32 P, or diluted with saline injected into the abdominal cavity to prevent cancer formation of ascites, malignant ovarian cancer has been with ascites, the catheter may produce ascites part, to be injected colloidal gold 98 or 32 P . It should be noted 98 of the radioactive colloid and 32 P for intraperitoneal injection, also caused radioactive hepatitis possible, it should be repeated in application check liver function for timely processing.

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Serous cystadenoma
Zhu serous tumor of the kidney from the body cavity epithelium, is the most common tumors of the ovary. According to national statistics, the total of 2007-09-07 16:00:00.1% of ovarian tumors common in women aged 30-40. The unilateral nature, but there are also many of the bilateral. Simple solution can be divided into gland capsule and two papillary serous cystadenoma.

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[Summary]

Ovarian cancer is a common cancer of female genital mutilation one of the incidence of cervical cancer and after cancer of the uterus, which ranked third. But ovarian cancer death, accounts of the first gynecologic tumors, right pose a serious threat to women's lives. Because ovarian embryonic development, organization anatomy and endocrine function more complicated, it may be suffering from benign tumors or malignant. Because of early ovarian cancer in asymptomatic, and the identification of its type benign and malignant very difficult, ovarian carcinoma laparotomy in ovarian tumor confined to only 30%, most have spread to the uterus, bilateral annex, the omentum and pelvic organs, both in the diagnosis of ovarian cancer and governance the treatment is a major problem indeed. Over the years experts on the pathological form of ovarian cancer, the development of clinical and treatment programs for many of accumulated a lot of experience, so far, statistics on domestic and foreign clinical data, the five-year survival rate of only 25% to 30%.

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The choice of ovarian cancer surgery, chemotherapy and radiotherapy. But because of its pathological type complex, qualitative, without a diagnosis and staging laparoscopy or laparotomy, it is difficult clear. In addition to surgery is not generally the case or have the type of tumor in patients with systemic conditions not competent to surgery, chemotherapy or radiotherapy to trial again after surgery to consider, as appropriate, generally the preferred treatment. Surgical exploration can be further defined tumor types and scope of involvement, clear staging, not only for postoperative chemotherapy and radiotherapy provide basis, and possible removal of the tumor, chemotherapy or postoperative radiotherapy or create conditions to improve efficacy.

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Primary tubal cancer is scarce. This cancer patients, the average age is 50 to 60 years old. Risk factors not yet well defined, however, chronic salpingitis or other inflammatory diseases (such as tuberculosis) may cause. Patients can have a long history of infertility.

Over 95% of the fallopian tube cancer is papillary serous adenocarcinomas; The minority is sarcoma. Its diffusion and similar ovarian cancer, tubal carcinoma can be directly extended disseminated, or through lymphatic vessels. With ovarian cancer staging similar symptoms, signs and diagnosis

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Clinical manifestations

(1) a <BR> symptoms, age occurred in perimenopausal women. Over more than 35 years of epithelial ovarian cancer, while those below the age of 35 occurred reproductive cell malignancies.
2, the pain may be due to malignant ovarian tumor of the changes, such as hemorrhage, necrosis, the rapid growth caused a considerable degree of persistent pain. The inspection found a local tenderness.
3, Irregular Menstruation see irregular bleeding, bleeding after menopause.
4, weight loss was sexually advanced thin.

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The cytological diagnosis of ovarian cancer cells, including shedding diagnosis and fine-needle aspiration cytology diagnosis learned of two parts. Check for gynecologic cytology clinical has for decades. Fine needle aspiration cytology lessons, the past 20 years in various tumor diagnosis has been widely used, this method of diagnosis of ovarian tumors of some value, advanced or recurrent tumors and lymph node metastases diagnosis, not only diagnosis, but also avoid some unnecessary laparotomy.

One, cytological diagnosis

(1) cytology examination: exfoliated cells can be obtained specimens from three aspects, including: ① vaginal, cervical and uterine tube; ② ascites or peritoneal fluid; ③ rectal deciduous uterine puncture lessons.

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Surgery

According to a medical examination and transvaginal ultrasound findings suspected ovarian cancer is often a laparotomy to be confirmed histology, and tumor stage and tumor debulking surgery. Histological need to be certified to remove ovarian cysts Mixed other causes, including non - epithelial ovarian cancer (such as interstitial or germ cell tumors), other primary site of tumor metastasis to the ovary (such as the adhesion of), or benign lesions, such as endometriosis. The adhesion is usually of signet ring cell tumor, representatives from primary adenocarcinoma of the stomach metastatic ovarian cancer. However, other parts of the original cancer, such as colon, appendix, the gallbladder and breast (special lobular invasive carcinoma) will also transfer to ovarian. At laparotomy surgery during the stage, right after the decision-making guidance provided important information, especially for patients with early (discussed below). Finally, the tumor debulking surgery (initial cytoreductive surgery) is the first of an important part of the operation because of residual tumor with a diameter of less than 1 cm larger than the residual tumor with a high survival rate.

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(1) of epithelial ovarian tumors
Most of age 30 to 60 years old. Divided into benign and malignant junction. The latter by the former number two to surface evolution. Borderline ovarian cancer tumor of 10 ~ 20%, a low-grade malignant potential, clinical course and prognosis between benign and malignant this; The biology of the slow growth, low rate of metastasis and recurrence later.

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Usually that cervical cancer is a certain type of human papilloma virus (HPV) caused. Now Johns Hopkins University researchers think that some head and neck cancer, particularly tongue and tonsil cancer with the following regional HPV infection. They also found that HPV-positive head and neck cancer prognosis, the other with head and neck cancer different.

V. said Dr. Keerti Shah, head and neck cancer usually is not a good prognosis, in the majority of patients the disease is advanced only found. However, HPV-positive cancer under the microscope is obvious characteristics, so pathologists can immediately determine whether the HPV-positive tumors.

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