Treatment of adult granulosa cell tumor of the ovary

In recent years, the incidence of gynecological diseases has been increasing, and many gynecological diseases are particularly prone to cancer if not treated in time. Among them, adult ovarian granulosa cell tumor is a relatively common gynecological disease in our lives. It is generally more common in middle-aged women, and severe abdominal pain will occur during the onset of the disease, so it must be treated in time. Let us learn about the treatment methods of adult ovarian granulosa cell tumor.

Treatment of adult granulosa cell tumor of the ovary

1. Western Medicine

1. Surgical treatment

1. Clinical Phase I:

Indications: Ovarian dissection and pathological examination are normal, the uterus has no lesions, and the peritoneal washing fluid cytology examination is negative.

Scope of surgery

(1) No rupture of the tumor capsule:

Infants, girls, and nulliparous women: unilateral adnexectomy and follow-up.

Women who have given birth and postmenopausal women: total hysterectomy and bilateral salpingo-oophorectomy.

(2) Rupture of tumor capsule:

Children, girls, and nulliparous women: unilateral adnexectomy and postoperative chemotherapy.

Women who have given birth and postmenopausal women: total hysterectomy with bilateral salpingo-oophorectomy and postoperative chemotherapy.

2. Clinical Phase II and above:

Tumor cytoreductive surgery was performed, and the entire uterus, bilateral adnexa, greater omentum, para-aortic and retroperitoneal lymph nodes, and metastases visible to the naked eye were removed.

The residual tumor should be less than 1 to 2 cm.

3. Recurrent tumor

Strive for another surgery.

2. Radiation therapy

It has certain therapeutic effects on patients with closed tumors, fixed pelvis, and those who find it difficult to perform a more thorough surgery.

It is one of the comprehensive treatment methods for patients with local recurrence after surgery and chemotherapy.

3. Chemotherapy

1. Indications:

① Patients after surgery with stage I and II or above capsular rupture.

②For patients who are temporarily unable to undergo surgery, it can be used before surgery.

2. Drug selection and compatibility: Currently, no drug as sensitive as bleomycin for endodermal sinus tumor has been screened for granulosa cell tumor.

A multi-drug combination chemotherapy regimen with cisplatin as the main drug is often used, which can be supplemented by progesterone, tamoxifen (tamoxifen), etc.

Common chemotherapy regimens:

(1) PAC: cisplatin, doxorubicin (adriamycin), and cyclophosphamide.

(2) PVB: vincristine, bleomycin, and cisplatin.

(3) VAC: vincristine, actinomycin D, and cyclophosphamide.

(4) Combined chemotherapy with bleomycin, etoposide (etoposide), and cisplatin.

Indications: Sex cord-stromal tumors with poor prognosis

3. Route of administration:

① Intravenous: the most commonly used and basic method of administration.

Mechanism: Drugs reach the whole body and affected areas through the circulatory system.

② Arteries:

Mechanism: Through super-selective arterial catheterization, chemotherapy drugs are directly injected into the blood vessels in the tumor blood supply area, resulting in high local drug concentration and causing tumor tissue necrosis.

③Intracavity:

Indications: Patients with pleural effusion, ascites or residual lesions in the abdominal cavity.

Function: Eliminate pleural effusion and ascites, and kill or inhibit residual lesions.

4. Treatment course:

In the first year after surgery, chemotherapy should be continued for 6 to 8 courses.

A second exploratory surgery is performed one year after surgery. If the result is negative, chemotherapy can be stopped. If it is positive, the chemotherapy regimen should be adjusted and chemotherapy should be continued or supplemented with other treatments.

2. Traditional Chinese Medicine

1. Traditional Chinese Medicine Prescriptions

1. Function:

(1) Used alone to treat tumors of all stages.

(2) Controlling tumor growth before surgery

(3) Prevent tumor recurrence after surgery.

(4) Used to correct anemia, leukopenia, gastrointestinal reactions, etc. during radiotherapy and chemotherapy.

2. Oral decoction

Leonurus, Prunella Vulgaris, Zedoaria leaf, Linderae scabra, Dragon bone, Cuscuta australis, Pyrola, Scutellaria barbata, Gastrodia elata seed, Lotus seed core, Honeysuckle, Toosendan seed, Adenophora stellaria, Cassia twig, Bamboo shavings, Panicum argentea, Tortoise shell, Turtle shell, Donkey-hide gelatin, etc.

Addition and subtraction:

Nausea: Add Pinellia, Scutellaria and ginger.

Thrombocytopenia: add raw rehmannia, herb agrimony, wolfberry and cistanche.

Poor appetite and abdominal bloating: add hawthorn, Shenqu and malt; add bamboo shavings, tangerine peel, coptis chinensis, perilla leaves and amomum for nausea and vomiting.

If there is excessive leucorrhea: add Poria, Atractylodes macrocephala, cuttlebone and lotus root node; if there is red and leucorrhea, add cuttlebone, Rubia cordifolia, Smilax glabra and Gardenia jasminoides.

Leukocytopenia: Add Cornus officinalis, Psoralea corylifolia, Curculigo orchioides, Polygonum multiflorum, Epimedium, or ginseng, Ligustrum lucidum, Ophiopogon japonicus, Eclipta prostrata, Moutan bark, or Radix Trichosanthis, cinnamon bark, and licorice.

Take the above prescription decocted in water once a day, 30 doses as a course of treatment.

3. Oral powder:

Acorus calamus, aloe vera, American ginseng, pearl, seahorse, centipede, cordyceps sinensis.

After processing, grind into fine powder and take 3 times a day, 1 to 2 grams each time. If you have difficulty swallowing the powder, you can put the powder into capsules, 0.5 grams per capsule, and take 2 to 4 capsules each time.

4. External use ointment:

Stephania tetrandra, frankincense, Corydalis yanhusuo, toad skin, Sanguisorba officinalis, myrrh, borneol, bezoar, etc.

It is refined into an external preparation for local application for those with significant pain. 2 to 3 times a day.

5. Topical dressings:

Qinjiao, Gastrodia elata, Yuanhu, Bupleurum, Curcuma, Evodia rutaecarpa, antelope horn, scorpion, centipede, borneol, etc.

Decoction in water, apply locally for 20 to 30 minutes each time, 1 to 3 times a day.

The above is an introduction to the treatment methods for adult ovarian granulosa cell tumor. When choosing a treatment method, we must combine it with our own condition. Among them, traditional Chinese medicine treatment methods are relatively free of any dangers and side effects, but the effect is relatively slow, so when choosing a treatment method, we must also listen more to the doctor's opinions and suggestions.