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恶性生殖细胞肿瘤治疗关键是规范化,包括手术切除肿瘤、手术病理分期、术后规范化疗,强调及时、足量、正规,可争取90%以上甚至100%的持续缓解率。初次化疗不规范,病情可能持续不缓解或复发。对于复发性恶性生殖细胞肿瘤,再次肿瘤细胞减灭术有减轻瘤负荷的作用,为术后的化疗奠定基础。复发性卵巢恶性生殖细胞肿瘤术后的二线化疗也至关重要。化疗药物应个体化,化疗的疗程数也强调个体化,有阳性肿瘤标志物的患者治疗应持续至肿瘤标志物降至正常后2个疗程。无阳性的肿瘤标志物的患者治疗应持续4~6个疗程。无性生殖细胞瘤和未成熟畸胎瘤对再次化疗或手术仍有效,预后好。卵黄囊瘤则效果很差。卵巢胚胎癌及原发绒癌很少见,治疗经验少。
Malignant germ cell tumor treatment is the key to standardization, including surgical excision of the tumor, surgical staging, postoperative standard chemotherapy, emphasizing timely, adequate, regular, and can fight for more than 90% or 100% of the sustained remission rate. The initial chemotherapy is not standardized, the condition may not continue to ease or relapse. For recurrent malignant germ cell tumors, tumor cytoreductive surgery again to reduce tumor burden, to lay the foundation for postoperative chemotherapy. Second-line chemotherapy for recurrent malignant germ cell tumors of the ovary is also crucial. Chemotherapy drugs should be individualized and the number of cycles of chemotherapy also emphasized individualized. Patients with positive tumor markers should be treated for up to 2 courses after tumor markers have been reduced to normal. Patients without positive tumor markers should be treated for 4 to 6 courses of treatment. Asexual germ cell tumors and immature teratomas are still effective for re-chemotherapy or surgery, the prognosis is good. Yolk sac tumor is very poor. Ovarian embryonal carcinoma and primary choriocarcinoma is rare, less experience in treatment.