Effect of Bevacizumab Combined with Neoadjuvant Chemotherapy in Advanced Ovarian Cancer and the Occurrence of Adverse Reactions

Objective: To explore the effect of bevacizumab combined with neoadjuvant chemotherapy in advanced ovarian cancer and the occurrence of adverse reactions. Methods: A total of 80 patients with advanced ovarian cancer, treated in Affiliated People’s Hospital of Inner Mongolia Medical University from June 2019 to December 2020, were randomly divided into two groups. In the chemotherapy group, 40 patients were treated with neoadjuvant chemotherapy, while in the combined group, another 40 patients were treated with bevacizumab combined with neoadjuvant chemotherapy. The therapeutic effects were compared at the end of the treatment cycle. Results: There was no significant difference in the levels of CA125, CEA, and VEGF between the two groups before treatment. However, after the treatment cycle, the levels of CA125, CEA, and VEGF in the combined group were significantly better than those in the chemotherapy group (P < 0.05). At the same time, the incidence of adverse reactions of the chemotherapy group was 67.50%, which was significantly higher than that of the combined group (35.00%; P < 0.05). Conclusion: Bevacizumab combined with neoadjuvant chemotherapy for patients with advanced ovarian cancer has significant curative effect. The combined therapy reduces the levels of tumor markers and inflammatory factors, improves patients’ quality of life, as well as reduces adverse reactions. It has high clinical promotion value.

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Role of Lymphadenectomy During Interval Debulking Surgery Performed After Neoadjuvant Chemotherapy in Patients With Advanced Ovarian Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.646135 ◽

2021 ◽

Vol 11 ◽

Author(s):

Minjun He ◽

Yuerong Lai ◽

Hongyu Peng ◽

Chongjie Tong

Keyword(s):

Ovarian Cancer ◽

Neoadjuvant Chemotherapy ◽

Residual Disease ◽

Advanced Ovarian Cancer ◽

Progression Free Survival ◽

Debulking Surgery ◽

Hazard Ratios ◽

Significant Difference ◽

Interval Debulking Surgery

ObjectiveThe role of lymphadenectomy in interval debulking surgery (IDS) performed after neoadjuvant chemotherapy (NACT) in advanced ovarian cancer remains unclear. We aimed to investigate the clinical significance of lymphadenectomy in IDS.MethodsWe retrospectively reviewed and analyzed the data of patients with advanced ovarian cancer who underwent NACT followed by IDS.ResultsIn 303 patients receiving NACT-IDS, lymphadenectomy was performed in 127 (41.9%) patients. One hundred and sixty-three (53.8%) patients achieved no gross residual disease (NGRD), and 69 (22.8%) had residual disease < 1 cm, whereas 71 (23.4%) had residual disease ≥ 1cm. No significant difference in progression-free survival (PFS) and overall survival (OS) was observed between the lymphadenectomy group and the no lymphadenectomy group in patients with NGRD, residual disease < 1 cm, and residual disease ≥ 1 cm, respectively. The proportions of pelvic, para-aortic and distant lymph node recurrence were 7.9% (10/127), 4.7% (6/127) and 5.5% (7/127) in the lymphadenectomy group, compared with 5.7% (10/176, P = 0.448), 4.5% (8/176, P = 0.942) and 5.1% (9/176, P = 0.878), respectively, in no lymphadenectomy group. Multivariate analysis identified residual disease ≥ 1 cm [hazard ratios (HR), 4.094; P = 0.008] and elevated CA125 levels after 3 cycles of adjuvant chemotherapy (HR, 2.883; P = 0.004) were negative predictors for OS.ConclusionLymphadenectomy may have no therapeutic value in patients with advanced ovarian cancer underwent NACT-IDS. Our findings may help to better the therapeutic strategy for advanced ovarian cancer. More clinical trials are warranted to further clarify the real role of lymphadenectomy in IDS.

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A retrospective analysis of neoadjuvant platinum-based chemotherapy versus up-front surgery in advanced ovarian cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200602001-00008 ◽

2006 ◽

Vol 16 (Suppl 1) ◽

pp. 47-53 ◽

Cited By ~ 7

Author(s):

H. Steed ◽

A. M. Oza ◽

J. Murphy ◽

S. Laframboise ◽

G. Lockwood ◽

...

Keyword(s):

Ovarian Cancer ◽

Neoadjuvant Chemotherapy ◽

Retrospective Analysis ◽

Advanced Ovarian Cancer ◽

Progression Free Survival ◽

Postoperative Chemotherapy ◽

Pleural Effusions ◽

Primary Surgery ◽

Platinum Based Chemotherapy ◽

Significant Difference

The objective of this study is to compare progression-free survival (PFS) and overall survival (OS) of ovarian cancer patients treated with neoadjuvant chemotherapy and surgery to primary surgery and postoperative chemotherapy. Retrospective analysis from 1998 to 2003 of 116 patients with ovarian cancer was performed. Fifty women diagnosed by positive cytology received three cycles of carboplatin and paclitaxel. Thirty-six patients subsequently underwent cytoreductive surgery and completed three further cycles postoperatively. The OS and PFS were compared in 66 women treated with primary surgery and postoperative chemotherapy. A statistically significant difference was observed for OS (P= 0.03, HR = 1.85, CI = 1.06–3.23) and PFS (P= 0.04, HR = 1.61, CI = 1.03–2.53) favoring the primary surgery group. Due to the small numbers, age, grade, stage, pleural effusions, and histologic cell type were controlled for separately in the bivariate analyses. Controlling for stage made the results weaker. A matched subgroup survival analysis was performed on patients who had surgery following neoadjuvant chemotherapy. After matching for stage and grade and controlling age and pleural effusions (N= 28 matched pairs), there was no statistical difference for OS (P= 0.95, HR = 1.04, CI = 0.33–3.30) or PFS (P= 0.79, HR = 1.11, CI = 0.98–1.04). It is concluded that primary surgery should be considered in all patients. Neoadjuvant chemotherapy may be an alternative in a subset of women with the intent to also perform interval debulking.

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The Outcomes of Primary Debulking Surgery and Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v4i2.86 ◽

2016 ◽

pp. 111

Author(s):

Dino Rinaldy ◽

Andrijono Andrijono ◽

Bambang Sutrisna

Keyword(s):

Ovarian Cancer ◽

Survival Rate ◽

Neoadjuvant Chemotherapy ◽

Advanced Ovarian Cancer ◽

Mean Value ◽

Ca 125 ◽

Perioperative Outcomes ◽

Debulking Surgery ◽

Chemotherapy Group ◽

Primary Debulking Surgery

Objective: To compare the outcomes and survival rate of primary debulking surgery with neoadjuvant chemotherapy. Method: We selected advanced ovarian cancer patients from medical records. Subjects were allocated into groups of primary debulking surgery and neoajuvant chemotherapy by considering the inclusion and exclusion criteria. We analyzed the data using T test, Fisher’s exact, and chi-square. The survival rate was presented in Kaplan Meier curve, whereas the significance was tested with Logrank. We managed the data using STRATA software version 12. Result: We obtained 32 cases of primary debulking surgery group and 20 cases of the neoadjuvant chemotherapy group. Most of the subjects (44.2%) were 40-49 years old and 80.8% had delivered more than twice. The mean value of Ca-125 at admission was 3,594.8 u/ml (range 66.6 to 73,000 u/ml). Total of 31 subjects showed the serous histologic type (59.6%). There was no association between primary debulking surgery and neoadjuvant chemotherapy for the parameter of operative time, blood loss, organs injury, ICU stay, and hospital stay (p>0.05). Primary debulking surgery had a survival rate similar to neoadjuvant chemotherapy group (p=0.95). Conclusion: The perioperative outcomes of advanced ovarian cancer patients has similar result between primary debulking surgery and neoadjuvant chemotherapy. Primary debulking surgery has a survival rate similar to neoadjuvant chemotherapy group. [Indones J Obstet Gynecol 2016; 4-2: 111-115] Keywords: advanced ovarian cancer, neoadjuvant chemotherapy, primary debulking surgery

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Neoadjuvant Chemotherapy Is Associated With Prolonged Primary Treatment Intervals in Patients With Advanced Epithelial Ovarian Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e3182013e2f ◽

2011 ◽

Vol 21 (1) ◽

pp. 66-71 ◽

Cited By ~ 14

Author(s):

Michael R. Milam ◽

Xia Tao ◽

Robert L. Coleman ◽

Robyn Harrell ◽

Roland Bassett ◽

...

Keyword(s):

Ovarian Cancer ◽

Neoadjuvant Chemotherapy ◽

Epithelial Ovarian Cancer ◽

Advanced Ovarian Cancer ◽

Disease Stage ◽

Perioperative Outcomes ◽

Cycle Number ◽

Significant Difference ◽

Advanced Epithelial Ovarian Cancer ◽

The Impact

Background:We evaluated the impact of neoadjuvant chemotherapy (NC) relative to primary surgery (PS) to determine if there was a difference in the total time and number of chemotherapy cycles given in patients with advanced epithelial ovarian cancer.Methods:We identified 263 consecutive women meeting eligibility from 1993 to 2005 for this institutional review board-approved study. Eligible patients in this analysis were those women with advanced disease (stage IIIC-IV) in whom a maximal cytoreductive effort was planned either at PS or after NC. Time to start chemotherapy was defined as follows: (1) NC group: confirmation of diagnosis through biopsy, cytological diagnosis from ascites, and pleural effusion; (2) PS group: confirmation of diagnosis from the date of surgery that confirmed the diagnosis of epithelial ovarian cancer. Total chemotherapy cycles: (1) NC group: NC chemotherapy cycles plus postoperative cycles; (2) PS group: chemotherapy after primary tumor debulking surgery. Clinical information evaluated included chemotherapy type, chemotherapy cycle number, total time to administer frontline chemotherapy, and survival.Results:Median chemotherapy cycles were greater in the NC group compared with the PS group (9 [range, 4-30] vs 6 [range, 3-19];P< 0.01). The PS group was also more likely to undergo chemotherapy regimens involving platinum and taxane treatment compared with the NC group (79% vs 65%;P= 0.017). Total time undergoing primary chemotherapy from initial diagnosis was greater in the NC group compared with PS (223 vs 151 days;P< 0.01). No significant difference was observed in overall survival and progression-free survival in the 2 groups.Conclusions:In patients with advanced ovarian cancer, NC followed by abdominal hysterectomy is associated with improved perioperative outcomes including optimal cytoreduction, decreased blood loss, and decreased inpatient hospitalization. In this cohort, NC was also associated with prolonged chemotherapy treatment intervals and increased chemotherapy cycles without improvement in survival.

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