Flashcards in B20. Radiotherapy, surgical and pharmacological treatment of vulvar, vaginal, and ovarian tumours Deck (15):
Ovarian chem treatment
Combination of cisplatin, paclitaxel, and bevacizumab.
For ovarian cancer patients with platinum sensitive BRCA mutation, a PARP-inhibitor called olaparib
Radiotherapy fo ovarian cancer?
Not used as often. Two methods to delivered to whole abdominal cavity called intraperitoneal radiation with colloidal radioisotopes or external beam whole abdominal cavity irradiation (WAR). Both rarely used.
Surgery for ovarian cancer?
Two types of cervical cancer from a surgical standpoint
Early invasive and locally advanced
What does cervical cancer surgery consist of?
Resection of the uterus, both ovaries and Fallopian tubes, and the omentum; also include pelvic and para-aortic lymphadenectomy
And if required splenectomy, hepatectomy, diaphragm resection.
When to do laparoscopic surgery?
1.) Histological sampling from disseminated, unresectable tumors before neoadjuvant chemotherapy
2.) Prophylactic surgery in the case of hereditary tumors (bilateral oophorectomy and resection of the Fallopian tubes). Effective surgery to reduce risk of ovarian cancer
Vulvar cancer treatment
G1 (less than 2 cm in diameter)?
Stage I/B (invasion exceeds I/B or lymph/vessel invasion?
G1- wide excision is sufficient
Stage I/B- radical vulvectomy and possible bilateral inguino-femoral lymphadenectomy
T1-T2 management of vulvar cancer
Post op external beam radiotherapy (in case of positive pelvic lymph nodes, 1 cm surgical margins, extensive inguinal metastasis, breach of capsule)
T3-T4 vulvar cancer treatment
Pre op chemo (cisplatin and 5-FU) and radiotherapy (EBRT or IMRT or brachytherapy)
What to do if the vaginal tumor is small?
Surgery is preferred
Invasive vaginal tumors are treated how?
If possible, treat with surgery. In advanced stages tumors are treated with radiotherapy
When to give post op radiotherapy to vaginal tumors
-Close or positive tumor surgical margins
What kind of radiotherapy is given to vaginal tumors
EBRT and intracavitary brachytherapy
What is done for tumors of the lower third of the vagina
Radiotherapy of inguinal lymph nodes is required with addition of surgery and pelvis irradiation