Sexcord/ stromal ovarian tumors medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Maneesha Nandimandalam, M.B.B.S.[2]

Overview

Adjuvant chemotherapy is usually considered for patients with poor prognosis.Hormone treatment is usually added for advanced granulosa cell tumors(GrCTs), given their frequent association with oestrogen dependence and usually indolent course Bone densitometry monitoring is indicated for patients receiving aromatase inhibitors

Medical Therapy

Chemotherapy

Adjuvant chemotherapy is usually considered for patients with poor prognosis factors such as: [1][2][3][4][5][6][7]

  • Large tumor size
  • High mitotic activity-index or
  • Ruptured tumors
  • BEP(bleomycin, etoposide, cisplatin) is the most accepted regimen even for recurrent disease that is refractory to hormone therapy

Hormonal therapy

Hormone treatment is usually added for advanced granulosa cell tumors(GrCTs), given their frequent association with oestrogen dependence and usually indolent course Bone densitometry monitoring is indicated for patients receiving aromatase inhibitors

References

  1. Nasioudis D, Orfanelli T, Frey MK, Chapman-Davis E, Caputo TA, Witkin SS, Holcomb K (March 2019). "Role of adjuvant chemotherapy in the management of non-granulosa cell ovarian sex cord-stromal tumors". J Gynecol Oncol. 30 (2): e19. doi:10.3802/jgo.2019.30.e19. PMC 6393626. PMID 30740951.
  2. Gershenson DM, Morris M, Burke TW, Levenback C, Matthews CM, Wharton JT (April 1996). "Treatment of poor-prognosis sex cord-stromal tumors of the ovary with the combination of bleomycin, etoposide, and cisplatin". Obstet Gynecol. 87 (4): 527–31. doi:10.1016/0029-7844(95)00491-2. PMID 8602303.
  3. Homesley HD, Bundy BN, Hurteau JA, Roth LM (February 1999). "Bleomycin, etoposide, and cisplatin combination therapy of ovarian granulosa cell tumors and other stromal malignancies: A Gynecologic Oncology Group study". Gynecol. Oncol. 72 (2): 131–7. doi:10.1006/gyno.1998.5304. PMID 10021290.
  4. Brown J, Shvartsman HS, Deavers MT, Burke TW, Munsell MF, Gershenson DM (September 2004). "The activity of taxanes in the treatment of sex cord-stromal ovarian tumors". J. Clin. Oncol. 22 (17): 3517–23. doi:10.1200/JCO.2004.12.074. PMID 15337800.
  5. Colombo N, Sessa C, Landoni F, Sartori E, Pecorelli S, Mangioni C (February 1986). "Cisplatin, vinblastine, and bleomycin combination chemotherapy in metastatic granulosa cell tumor of the ovary". Obstet Gynecol. 67 (2): 265–8. PMID 2418394.
  6. Brown J, Shvartsman HS, Deavers MT, Ramondetta LM, Burke TW, Munsell MF, Gershenson DM (May 2005). "The activity of taxanes compared with bleomycin, etoposide, and cisplatin in the treatment of sex cord-stromal ovarian tumors". Gynecol. Oncol. 97 (2): 489–96. doi:10.1016/j.ygyno.2005.01.011. PMID 15863149.
  7. Tao X, Sood AK, Deavers MT, Schmeler KM, Nick AM, Coleman RL, Milojevic L, Gershenson DM, Brown J (September 2009). "Anti-angiogenesis therapy with bevacizumab for patients with ovarian granulosa cell tumors". Gynecol. Oncol. 114 (3): 431–6. doi:10.1016/j.ygyno.2009.04.021. PMC 4263417. PMID 19524286.

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