The ovarian cancer is a complex association of several measures including treatment which  aims improving the survival time. Therapeutic intervention  is made according to the clinical stage. Treatments of ovarian  cancer may be: surgery, chemotherapy, radiotherapy, hormone  therapy, immunotherapy. Surgery intervention  has priority over other therapeutic ones. A complete and correct  initial surgery is crucial for the treatment of ovarian cancer.Subsequent therapy  success is largely determined by the initial surgical instrument. Surgical excision was  practiced in borderline ovarian tumors (border line) and ovarian cancers  stadium I and II.  Exfoliated cancer cells  in the peritoneal cavity can always generate great new tumors.

Consider now that only  patients in stages I and IB tumors with well / medium differentiated in  terms of histology, do not require adjuvant therapy. In over two thirds of  women diagnosed of ovarian cancer in stage II and III, the tumor is  disseminated in the pelvis,  creating an appreciably tumor mass . The surgical act in these  cases is ment to remove the largest part of the lesions , therefore the  residual mass rather  than the quantity of the removed tumor mass is crucial for the  subsequent evolution. Despite the extensive  primary surgery, many patients with ovarian cancer die. Starting from this  observation, it was proposed a new implementation of a control  intervention  (a second look - with thw examination of abdomen and  pelvis, following the same procedure as in  primary surgery case). If there are obvious  tumor masses, the pelvic lymph and paraaortic nodes must be biopsies. Residual tumor mass  should be resected if possible.

2. Chemotherapy.
Adjuvant therapy is the  main method used to aply surgical or initial treatment of advanced  ovarian cancers. Chemotherapy may be  applied as: alone or by polichemotherapy:

a. Monotherapy Agents are mainly used  alkilanti agents (melphalan, Clorambucil, Ciclophosphamida, Thiotepa),  but Carboplatin, Cisplatin, Doxorubicin, Nexametilmelamina, Taxol.
b. Politherapy. Combined chemotherapy  have a complete response between 20-90% (significant improvement of  survival). The combination can  include: two chemotherapy (CTX, cisplatin), three chemotherapy  (cisplatin, doxorubicin, Ciclophosphamida) or 4 chemotherapy  (Hexametilmelamina, Ciclophosphamida, Metrothexate, 5-fluorouracil). In conclusion,  chemotherapy has its well established place in treating ovarian cancer,  it is necessary even in the adjuvant treatment of stage I disease and it  is the most important in advanced stages.



3. Radiotherapy. Is used as adjuvant  therapy in ovarian cancer after maximal surgical citoreduction, for  treatment applied on the inoperable tumors that do not respond to  chemotherapy. This therapy "rescues" patients with persistent disease  after primary treatment, chemotherapy and second-look surgery. It can be used as a  palliative treatment for patients with pelvic masses or metastases  (brain, liver, bone). Radioisotopes used are:  The 196 and P 32. Dose and dose  fractionation schedules irradiating tumoricide represents a compromise  between the doses needed for tumor mass destruction and the danger of  significant aggression of the normal tissues. In conclusion,  radiotherapy is a feasible method to treat ovarian cancer, but it has  its own rolw in the after surgery and  chemotherapy treatment .

4. Hormone therapy.
The introduction of  hormonal therapy in the ovarian cancer treatment was not based on the  presence of estrogen and progesterone receptors. The preparations used  were: Megace, medroxyprogesterone, tamoxifen. Here, enter into discussion the  young women with stage IA and border-line tumors.



5. Immunotherapy.
This method uses  administration of interferon gamma, TNF, IL-2, Lak, Corynebacterium  parvum vaccine, melphalan, levamisole, BCG, Polidin. The nonspecific  immunotherapy associated with chemotherapy proved to be active in  the  ovarian cancer, but its singular use is still ambiguous.