I. Status of chemotherapy 1. Chemotherapy has become one of the important means of treating malignant tumors. 2.Radical chemotherapy, adjuvant chemotherapy, palliative chemotherapy. 3.The irregularity of chemotherapy has led to the increase of drug-resistant cases. The purpose of chemotherapy 1.Radical chemotherapy, adjuvant chemotherapy, palliative chemotherapy. 2.According to different diseases have different purposes. Malignant trophoblastic tumor: radical, 99% cure rate of invasive dextrous stage I, 80% cure rate of choriocarcinoma stage I. Endometrial cancer: it is the second solid tumor after choriocarcinoma, which can be controlled by chemotherapy or even cured by distant metastasis. Malignant germ cell tumor of ovary: conservative surgery plus effective chemotherapy can significantly improve the cure rate and preserve reproductive function. Ovarian epithelial carcinoma: surgery plus chemotherapy, responding to chemotherapy in 70% of cases. Cervical cancer: preoperative neoadjuvant chemotherapy can significantly shrink the tumor and improve the surgical clearance rate. Vulvar cancer, vaginal cancer, genital sarcoma and melanoma: they are not sensitive to chemotherapy and are only used as adjuvant to surgery and radiotherapy or palliative treatment for recurrence. Principles of chemotherapy 1. Clear diagnosis, must have pathological diagnosis, except for trophoblastic tumor. 2. Standardized drug use, no arbitrary reduction of dose, course of treatment, or extension of treatment interval. 3.Individualized treatment, chemotherapy regimen and drug selection, dose, usage and route are decided according to the disease type, clinical stage, tumor site, prognosis score and patient’s physical ability score. Indications and contraindications of chemotherapy Indications: 1. Tumors highly sensitive to chemotherapy, such as malignant trophoblastic tumors, are the first choice for chemotherapy. 2. 2.Patients who have chemotherapy indications and need comprehensive treatment (those who need adjuvant chemotherapy before and after surgery). 3.Patients with advanced tumor who have no indication for surgery and radiotherapy, or patients with recurrence and metastasis after surgery or radiotherapy. Contraindications: 1.Total white blood cell count below 4.0×109/L, neutrophil below 2.0×109/L, platelet below 80×109/L. 2.Patients with moderate or severe liver and kidney function abnormalities (use with caution for mild abnormalities). 3.People with cardiac dysfunction, anthracycline anticancer drugs are not used. 4.Persons with general condition failure. 5.Patients with serious infection. 6.Patients with mental illness who cannot cooperate. 7.Allergic patients should be used with caution, and those who are allergic to the anticancer drugs used should not be used. 8. Pregnancy combined with tumor depends on the pregnancy week and nature of tumor. Before chemotherapy: 1. The diagnosis must be clear and pathologically confirmed (except trophoblastic tumor). The choice of chemotherapy regimen should be based on the site of tumor, histological type, patient’s body surface (or weight), physical condition, bone marrow, liver, kidney function and cardiac function, etc., to make a comprehensive assessment, accurately select the chemotherapy regimen, determine the drug dose, method and route of administration. 2. Body surface area (m2) is the basic parameter to determine the drug dose. It can be deduced from the patient’s height (m) and weight (kg). The measurement of weight must be accurate. 3.Activity status: Currently, the Kamofky (KPS) activity status score and the simplified activity status score of Zubrod-ECOC-WHO (ZPS) of the Eastern Cooperative Oncology Group are commonly used internationally (Table 1).KPS score less than or equal to 40 or ZPS score more than 3 are generally not suitable for chemotherapy.