激素治疗在复发或难治型卵巢颗粒细胞瘤中的应用

Hormonal therapy of advanced or relapsed ovarian granulosa cell tumor

卵巢颗粒细胞瘤有特殊的激素活性，治疗以手术为主，短期预后良好，有远期复发的特点。进展期和复发型颗粒细胞瘤的治疗方法有限，尚无标准的治疗方案。与放化疗相比，激素治疗无严重的不良反应，长期使用易被接受。越来越多的学者开始尝试在进展期复发型颗粒细胞瘤中应用激素治疗药物，以延长无瘤间期、减慢疾病进程。激素联合应用可能达到更好的效果。未来的研究应致力于找出使临床获益最大的激素治疗药物，比较不同方案联合应用的效果，以及合成能高选择性地激动颗粒细胞瘤中雌激素受体β的药物。

Ovarian granulosa cell tumor is a rare gynecologic malignancy with hormonal activity. Surgical excision is the standard treatment for this disease. Most patients present excellent short term prognosis, however, late relapse often occurs, even after many years. Viable treatments of advanced or relapsed granulosa cell tumor are still limited, and the optimal therapy method has not been established. Compared with chemotherapy and radiotherapy, hormonal therapy is a well-tolerated treatment which can be administrated over a long period of time without serious side effects, and the combined application of hormones may achieve a better outcome. Therefore, hormonal therapy has been suggested as a potential treatment option for patients with advanced or relapsed granulosa cell tumor, and to extend the tumor-free interval and attenuate the disease progression. Future researches should be focused on the identification of the hormonal therapy which may provide the greatest clinical benefit, comparing and analyzing the effects of different combined therapeutic regimens of hormone drugs, and on the synthesis of drugs highly activating estrogen receptor β expressed in the granulosa cell tumor cells.