How to treat ovarian cancer recurrence after surgery

Postoperative recurrence of ovarian cancer can be treated through reoperation, chemotherapy, targeted therapy, immunotherapy, radiotherapy and other methods. Recurrence may be related to factors such as residual tumor, gene mutation, drug resistance, etc., and usually manifests as pelvic mass, ascites, elevated CA125 and other symptoms.

1. Reoperation

For patients with locally recurrent disease and physical condition permitting, secondary cytoreductive surgery may be considered. Surgery needs to evaluate the scope of the lesion and the benefit of surgery. If R0 resection can be achieved, survival can be prolonged. Postoperative adjuvant treatment is required to reduce the probability of recurrence.

2. Chemotherapy

Non-platinum regimens such as gemcitabine combined with docetaxel can be used for platinum-resistant relapses, and platinum-containing regimens such as carboplatin combined with paclitaxel are preferred for platinum-sensitive relapses. The chemotherapy regimen needs to be adjusted based on the platinum-free interval, previous medication history, and genetic testing results. Adverse reactions such as bone marrow suppression need to be monitored during medication.

3. Targeted therapy

The PARP inhibitor olaparib tablets are suitable for patients with BRCA mutations and can prolong progression-free survival. Bevacizumab injection combined with chemotherapy can inhibit tumor angiogenesis. Genetic testing and cardiovascular evaluation are required before medication.

4. Immunotherapy

The PD-1 inhibitor pembrolizumab injection can be used for patients with high microsatellite instability relapse. PD-L1 expression and tumor mutation load need to be detected before treatment, and adverse reactions such as immune-related pneumonia need to be alerted during use.

5. Radiotherapy

Three-dimensional conformal radiotherapy can be considered for local recurrence to relieve pain or bleeding symptoms. Radioactive seed implantation is suitable for isolated lesions, and whole-abdominal radiotherapy is now rarely used. During radiotherapy, care must be taken to protect normal tissues such as the intestines.

Patients with recurrence should maintain a high-protein diet such as fish, meat, eggs, and milk, and supplement with appropriate amounts of vitamin D and calcium. Aim for 150 minutes of moderate-intensity exercise such as brisk walking each week and avoid weight training. Regularly review tumor markers and imaging, and seek medical advice promptly if abdominal distension and pain occur. Psychological support is important to improve treatment compliance, and you can participate in anti-cancer community activities.