前言：卵巢顆粒層細胞瘤在分類上屬於性索間質細胞，約佔卵巢腫瘤的2-5%。其中成人型佔卵 巢顆粒層細胞瘤的95%之多，好發在50到55歲的女性。腫瘤分期是卵巢顆粒層細胞瘤最重要的 預後因子，第一期的十年整體存活率為84-95%，第二期為50-65%，第三及第四期為0-22%。 病例報告：一個56歲的女性，因為左側卵巢顆粒層細胞瘤在臨床分期至少有第三期，所以 於西元2002年2月23日接受減積手術。術後，她接受以撲累惡注射劑（Bleomycin）、順鉑 （Cisplatin）與依托泊甙（Etoposide）為處方的輔助性化學治療共四個療程。接著接受輔助性全 腹腔骨盆腔放射線治療21次，劑量為25.2 Gy。完成之後，再接受骨盆腔放射線治療11次，劑 量為19.8 Gy。自結束療程至今，她都規則在本院追蹤，且沒有任何腫瘤復發或疾病繼續進展的 現象。 討論：至今對於患有卵巢顆粒層細胞瘤的病人仍然沒有標準和公認明確有效的治療方法，特別 是第三四期，或是復發以後無法開刀的患者。面對這個疾病，通常手術切除是第一線的治療方 式。在化學治療方面，以順鉑為主的處方選擇至今也未能有清楚的指引。輔助性放射線治療的 角色也沒有確定。近期，有一篇研究指出輔助性放射線治療有助於治療卵巢顆粒層細胞瘤。有 另一篇研究指出緩和性放射線治療對緩解病人的症狀有正面的幫助。因此，我們建議在特定的 卵巢顆粒層細胞瘤患者上，輔助性放射線治療應可改善預後。

Introduction : Granulosa cell tumor (GCT) of the ovary is classified as a sex cord stromal tumor, representing approximately 2-5% of ovarian neoplasms, and adult type accounts 95% of all GCTs, usually occurs in women during 50-55 years old. The most important prognostic factor of this tumor is stage, with 10-year overall survival of 84-95% for stage I tumors, decreasing to 50-65% for stage II tumors, and to 0-22% for stage III and IV disease. Case report : A 56-year-old woman with left side ovarian granulosa cell tumor, at least clinical FIGO stage IIIa, underwent debulking operation on February 23rd, 2002. After surgery, she received four cycles adjuvant chemotherapy with the regimen of Bleomycin, Cisplatin and Etoposide. Then she received postoperative whole-abdomen and pelvis irradiation. The dose was given 2520 cGy in 21 fractions with liver and kidney shielding. After whole-abdomen and pelvis irradiation, she received pelvis boost with the dose of 1980 cGy in 11 fractions. Since then, she was regularly followed at our hospital until now without any signs of tumor recurrence nor tumor progression. Discussion : Until now there is no standard and proven treatment for GCT patients, especially when they suffered from advanced-stage or recurrent unresectable tumors. Complete tumor resection should be considered as the primary treatment. The optimal choice of combination platinum-based chemotherapy is still not well-defined. The role of adjuvant radiation therapy remains controversial. We suggested that adjuvant RT for patients with GCT might improve outcomes in selected patients.