Application Of Neoadjuvant Chemotherapy In The Treatment Of Advanced Epithelial Ovarian Cancer

Objective: To evaluate the value of neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer.To observe the responsiveness of patients to neoadjuvant chemotherapy and explore possible predictors of response to neoadjuvant chemotherapy,so as to provide reference for the selection of reasonable and effective treatment options.Method: The clinical data of 234 patients with primary epithelial ovarian cancer at stage IIIC and IV(FIGO staging)admitted to Shengjing Hospital Affiliated to China Medical University from January 1,2010 to December 31,2015 were retrospectively analyzed.150 patients underwent primary debulking urgery(PDS)and 84 patients underwent neoadjuvant chemotherapy(NACT)combined with intermittent cytoreductive surgery(IDS)and were divided into IDS group.The basic characteristics,intraoperative conditions and perioperative complications of the two groups were compared.Progressive-free survival(PFS)and overall survival(OS)were compared between the two groups.PFS and OS in patients with different reactions to neoadjuvant chemotherapy were compared.To compare the basic and pathological characteristics of patients with and without neoadjuvant chemotherapy,and to study the possible predictors of neoadjuvant chemotherapy response.Result: In IDS group,the operation time was shorter,the estimated amount of bleeding was less,the probability of blood transfusion was lower,the rate of intestinal resection was smaller,and the hospitalization time was shorter.The difference was statistically significant(P<0.05).The success rate of satisfactory cytoreductive surgery in IDS group was higher(P=0.006).There was no significant difference in PFS and OS between the two groups(P>0.05).The PFS and OS of patients with NACT response were higher than those without NACT response(P <0.05).The initial serum CA125 value was related to the response of neoadjuvant chemotherapy(P = 0.024).Patients with initial serum CA125 value < 1464 U/ml might respond to neoadjuvant chemotherapy.Conclusion: Neoadjuvant chemotherapy can reduce the focus of tumors,reduce perioperative complications and improve the probability of satisfactory tumor reduction.The prognosis of patients responding to neoadjuvant chemotherapy is better than that of patients not responding to neoadjuvant chemotherapy.The initial CA125 value has a certain role in predicting the reactivity of neoadjuvant chemotherapy.