Abstract
An 82-year-old female was diagnosed with ovarian cancer in May 2004. Following gynecological surgery, pathological evaluation showed stage IIIC epithelial ovarian cancer. From June 2004 to January 2005, the patient received six cycles of conventional treatment combined with intravenous paclitaxel (Taxol®) and cisplatin. The patient developed abdominal distension and experienced a gradual deterioration in health during 2007, with admission to The First Affiliated Hospital in May 2007. The patient presented with severe abdominal distension and breathing difficulty on May 15 and appeared to be in critical condition. Ultrasound examination revealed massive ascites and left-side pleural effusion. Thoracentesis and abdominocentesis were performed, and 300 mg carboplatin was administered intraperitoneally on May 19, followed by a second abdominocentesis on May 21. However, these treatments did not alleviate the symptoms, and 200 mg bevacizumab was administered by intravenous infusion on May 27. The condition of the patient gradually improved and 400 mg bevacizumab was administered by intravenous infusion every two weeks from June 9. From December, the dosage of bevacizumab was reduced to 200 mg every two weeks. In addition, 300 mg carboplatin was administered intraperitoneally on November 4 and intraperitoneal carboplatin chemotherapy was repeated thereafter. The patient exhibited disease-free survival until July 2009, at which time disease progression was observed and the cancer recurred in August 2009. The patient died of multiple organ failure in September 2009. Bevacizumab rapidly eliminated the patient’s massive ascites and pleural effusion, and achieved an effect that was not possible with other treatments. Therefore, bevacizumab is an effective therapy for late-stage relapse and refractory ovarian cancer.
Highlights
Ovarian epithelial carcinoma is one of the most common gynecological cancers [1]
Patients treated with IP paclitaxel/cisplatin chemotherapy have been observed to live significantly longer lives than those treated with IV paclitaxel/cisplatin chemotherapy, which indicates that IP administration is the optimal route for ovarian cancer treatment [4]
In the present case study, massive effusion in the thoracic and abdominal cavity disappeared within a short time‐frame subsequent to bevacizumab administration, thereby providing a basis for the treatment
Summary
Ovarian epithelial carcinoma is one of the most common gynecological cancers [1]. Once clinical symptoms are apparent, patients have developed mid‐ to late‐stage ovarian cancer, at which point aggressive treatments may yield more favorable results than conservative ones. Surgery remains the primary treatment for stage III ovarian cancer and allows removal of gross disease. Intravenous (IV) or intraperitoneal (IP) chemotherapy extends the survival time of patients and is associated with superior results for recurrent ovarian cancer relative to other treatment modes. Patients treated with IP paclitaxel/cisplatin chemotherapy have been observed to live significantly longer lives than those treated with IV paclitaxel/cisplatin chemotherapy, which indicates that IP administration is the optimal route for ovarian cancer treatment [4]. The patient's condition continued to decline with the development of severe abdominal distension, breathing difficulties and an inability to eat on 15 May. Ultrasound (iU33; Philips Ultrasound, Bothell ,WA, USA) showed massive ascites and left pleural effusion, and the patient appeared to be in a critical condition. The patient died of multiple organ failure in September 2009
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