Comparison of Neoadjuvant Chemotherapy Efficiency in Advanced Ovarian Cancer Patients Treated With Paclitaxel Plus Carboplatin and Intraperitoneal Bevacizumab vs. Paclitaxel With Carboplatin.

Yin Tao,Xing Li,Cheng-Fang Zhou,An-Shan Wu,Xue-Ting Tang,Hou-Shen Zhou

doi:10.3389/fmed.2022.807377

Abstract

ObjectiveThis study evaluated the role of neoadjuvant chemotherapy (NACT) with bevacizumab intraperitoneal perfusion in advanced ovarian cancer (AOC).MethodsIn this study, 80 patients with advanced epithelial ovarian cancer (stage IIIc or IV) who received NACT at the Central Hospital of Zhuzhou between February 2019 and October 2020 were enrolled. Patients were randomized to receive paclitaxel plus carboplatin (TC) or TC plus intraperitoneal perfusion of bevacizumab (TCB). The effect of chemotherapy was assessed following two cycles of chemotherapy. Cancer antigen 125 (CA125), tumor size, ascites volume, bleeding volume, duration of operation, surgical satisfaction rate, complication rate, and residual tumor were assessed to monitor response to chemotherapy.ResultsTreatment with TCB regimen significantly reduced serum levels of CA125 and ascites volume (p < 0.001). Meanwhile, the TCB group had significantly lower intraoperative blood loss and shorter operation time (p < 0.001). Most importantly, patients treated with TCB regimen had a higher surgical satisfaction rate (p < 0.01). Moreover, the incidence of postoperative wound infection, hypoproteinemia, abdominal distension, and fever was lower in the TCB group compared with the TC group. Assessment of adverse reactions during chemotherapy showed no severe complications between the two groups.ConclusionsThe results demonstrated that the TCB regimen is superior to the TC regimen alone in the treatment of AOC. These findings could help improve the surgical satisfaction rate, provide more effective treatment strategies to prolong progression-free survival and reduce postoperative complications, and promote surgical recovery in AOC.

Highlights

The other 40 subjects were treated with a TC regimen and considered the control group
Between February 2019 and October 2020, 80 patients were screened for age, Federation of Gynecology and Obstetrics (FIGO) stage, and tumor type, without differences between the two groups at the Zhuzhou Central Hospital study sites (Table 1)
We demonstrated that the incidence of gastrointestinal reaction has no significant difference between TC and TC plus i.p. perfusion BV (TCB) groups

Summary

Introduction

Ovarian cancer is one of the most common malignancies of female reproductive organs after cervical and endometrial cancer [1]. About 70% of patients with ovarian cancer are advanced, and 70% relapse after surgery [5, 6]. This could be because factors such as the deep-seated location of the ovaries within the pelvic cavity, small tumor volume, and lack of characteristic symptoms hinder diagnosis. Multiple metastases to the peritoneum, mesenteric, and intestinal surfaces in patients with advanced ovarian cancer (AOC, stage III-IV) complicate surgical treatment [9]. To achieve R0 resection for stage III-IV AOC, several studies have proposed neoadjuvant chemotherapy (NACT), which is recommended by NCCN [11]

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Discussion

Conclusion