[Clinical practice guidelines: Standards, Options and Recommendations for first line medical treatment of patients with ovarian neoplasms (summary report)].
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Ошибки и ограничения
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Lhommé Catherine, Ray-Coquard Isabelle, Guastalla Jean-Pierre, Bataillard Anne, Thomas Laurence, Bonnier Pascal, Dargent Daniel, Dohollou Nicole, Ganem Gérard, Lefranc Jean-Pierre, Misset Jean-Louis, Rixe Olivier, Tchiknavorian Xavier, Tournigand Christophe, Villet Richard, Bachelot Thomas, Kerbrat Pierre, Fervers Béatrice, Basuyau Jean-Pierre, Cohen-Solal-Le Nir Christine, Morice Philippe, Duvillard Pierre, Voog Eric, Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC), Fédération Hospitalière de France (FHF), Fédération Nationale de Cancérologie des Centres Hospitaliers Régionaux Universitaires (FNCCHRU), Fédération Française de Cancérologie des Centres Hospitaliers Généraux (FFCCHG), Centres Régionaux de Lutte Contre le Cancer (CRLCC), Société Française d'Oncologie Gynécologique (SFOG)
Аннотация
OBJECTIVE: To update clinical practice guidelines for first line medical treatment of patients with ovarian neoplasms in collaboration with the French Society for Gynaecologica Oncology.
METHODS: The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts. The CPGs are defined following the definitions of the Standards, Options and Recommendations project. Once the guideline has been developed, the document is submitted for review by independent reviewers.
RESULTS: This article is a summary version of the full document presenting the clinical practice guidelines with algorithms. After surgery, most patients with ovarian neoplasms need adjuvant medical treatment. These guidelines concern the initial medical treatment (chemotherapy, hormone treatment and immunotherapy) and potential consolidation treatment. To complete the indications, two alternative treatment strategies are taken into account: no treatment and radiotherapy. This updated version concerns the indications and the modalities of chemotherapy. The main modifications are: 1) first-line chemotherapy for ovarian neoplasm can be taxane-platinum or carboplatine alone; 2) poly-chemotherapy is no longer a standard; 3) for early stages, except for stage IA grade I non-clear-cell tumours, adjuvant chemotherapy should be preferred to no treatment; 4) chemotherapy is standard for all stage III tumours, irrespective of the surgical result; 5) for stage IA G2-3 to IIA tumours, complete surgical staging and determination of the histological grade are standards.