大多数卵巢癌患者在一线化疗后 3 年内复发。因此，在复发情况下选择最合适的治疗对于确定患者的预后具有重要作用。治疗选择包括全身和腹腔内化疗、二次细胞减灭术和立体定向全身放射治疗。最佳治疗选择取决于多种因素，而不仅仅是无治疗间隔。对于全身治疗，应考虑既往治疗、残留毒性、合并症、体能状态和患者偏好。对于可以预测肿瘤完全切除的患者和患有寡转移性疾病的患者，可以建议进行二次细胞减灭术。立体定向全身放射治疗是寡转移性疾病手术的有效替代方案，具有较高的局部控制性和最小的毒性。目前的证据表明，BRCA 突变状态和分子分析在影响全身和局部治疗的反应中发挥着新的作用。因此，这些可以为治疗决策过程提供指导，并帮助确定对聚（ADP-核糖）聚合酶（PARP）抑制剂或免疫疗法或手术联合疗法（而不是铂类化疗）反应更好的患者。目前该领域的知识可以帮助扩大治疗选择，特别是对于铂类耐药的患者。在这篇综述中，我们概述了化疗、放疗和手术在这种情况下的作用及其对临床实践和治疗决策过程的影响，以便为患者提供最佳的定制治疗患有复发性卵巢癌。© IGCS 和 ESGO 2024。禁止商业重复使用。请参阅权利和权限。英国医学杂志出版。

The majority of patients with ovarian cancer relapse within 3 years of first line chemotherapy. Therefore, choosing the most appropriate treatment in the recurrence setting has a fundamental role in defining a patient's prognosis. Treatment options include systemic and intra-peritoneal chemotherapy, secondary cytoreductive surgery, and stereotactic body radiotherapy. The best therapeutic choice depends on multiple factors and not only on treatment-free interval. For systemic therapy, prior lines therapy, residual toxicities, comorbidities, performance status, and patient preferences should be taken into account. Secondary cytoreductive surgery can be proposed in patients in which complete tumor resectability can be predicted and in those with oligometastatic disease. Stereotactic body radiotherapy represents a valid alternative to surgery for oligometastatic disease with high local control and minimal toxicity. Current evidence has demonstrated an emerging role of BRCA mutational status and molecular profiling in the impacting response to systemic and local treatments. Therefore, these could provide guidance in the treatment decision process and help identify patients who respond better to poly(ADP-ribose) polymerase (PARP)-inhibitors or immunotherapy or to a combined approach with surgery rather than to platinum-based chemotherapy. Current knowledge in this field could help widen therapeutic options, especially for platinum-resistant patients. In this review, we offer an overview of the state of the art regarding the role of chemotherapy, radiotherapy, and surgery in this setting and their implications in clinical practice and in the treatment decision process, so as to provide the best tailored therapy in patients with recurrent ovarian cancer.© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.