Authors
1
Department of Medical Oncology, College of Medicine, National Teaching oncology hospital, Iraq
2
Oncology Teaching Hospital, Medical City Complex
,
Document Type : Research Paper
Abstract
Background: Ovarian cancer is the most lethal malignancy of female genital tract. Epithelial ovarian cancer comprises the majority of malignant ovarian neoplasms, response rate to platinum, taxan and bevacizumab is excellent in advance stages of disease, despite that recurrence can occur.
Aims: To estimated response rate to first line chemotherapy (platinum and taxane with bevacizumab) and progression free survival (PFS) in patients with advanced epithelial ovarian cancer (OC).
Patients and Methods: A total of 50 patients with OC were enrolled in this cross-sectional study whom received chemotherapy protocols (carboplatin ,paclitaxel and antiangiogenesis { bevacizumab} /Carboplatin) cycle and each cycle repeated every 3 weeks. A response evaluation criterion in solid tumors guidelines was used. Also comparison between primary debulking surgery (PDS) and interval debulking surgery (IDS) in progression free survival (PFS) was measured.
Results: The median baseline level of CA125 was 695 U/ml (range= 9.2-5000 U/ml) compared with 54.6 (range= 5.0-27 U/ml) after treatment (p value < 0.001). The mean ovarian mass before treatment was 6.9±2.62 cm which reduced to 2.5±2.61 cm after treatment (p= 0.001). Similarly, the frequency of lymphadenopathy and ascites decreased from 72% and 68%, respectively before treatment to 22% and 18%, respectively after treatment (p<0.05). One woman (2%) showed disease progression, 3 patients (6%) were stable, 42 patients (84%) had partial response and 4 patients (8%) had complete remission. Mean PFS time for IDS was 19.5±2.82 months, 95%CI= 13.97-25.03 compared with 8.5±2.82 months in PDS, 95%CI= 4.54-12.46 (p=0.008).
Conclusions: Platinum and taxan based with bevacizumab showed effective treatment regime for management of advanced OC and serum level of CA125 could be effectively used in monitoring the disease progression and response. Interval debulking surgery was more effective compared to primary debulking surgery and PFS was better in patient who is done IDS than in patient in PDS.
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