Clinical Study Of Intraperitoneal Injection Bevacizumab Combined With Chemotherapy In Treatment Of Malignant Ascites Of Ovarian Cancer

Objective: To observe the efficacy and safety of intraperitoneal injectionbevacizumab (Avastin) plus chemotherapy in ovarian cancer ascites, meanwhile,to analyze the clinical significance of vascular endothelial growth factor (VEGF)and CA-125level variance in ascites during the treatment.Methods: Patients with ovarian cancer ascites were randomly assigned to receiveeither chemotherapy only (n=27)(TC regimen: Paclitaxel135mg/m2+CarboplatinAUC=5, iv., d1, every3weeks and intraperitoneal Cisplatin:40mg/m2every2weeks, for6weeks) or intraperitoneal injection bevacizumab (300mg, every2weeks for6weeks) plus chemotherapy (n=31). The efficacy, quality of life (QOL),adverse effect of the treatment were analyzed and VEGF and CA-125level inascites were detected by ELISA in all patients.Results: The overall response rate (ORR) in bevacizumab plus chemotherapygroup was significantly higher than with chemotherapy only (ORR:90.32%vs59.26%, P<0.05). During treatment, the times of ascites drainage treatment inbevacizumab plus chemotherapy group was reduced than chemotherapy alonegroup (P<0.05). After treatment, the flow rate of ascites in bevacizumab pluschemotherapy group was slowed than that in chemotherapy alone group (P<0.05).QOL improvement rate of bevacizumab plus chemotherapy group was alsosignificantly higher than chemotherapy only (93.55%vs48.15%, P<0.05). Allpatients were well tolerated and no serious adverse effect was found. Aftertreatment with bevacizumab plus chemotherapy, VEGF and CA-125level inascites in experimental group was significantly decreased compared withbaseline(P<0.05). Meanwhile, ascites VEGF and CA-125level was significantlylower with bevacizumab plus chemotherapy than chemotherapy only (P<0.05).Conclusions: Applied TC treatment programs, the efficacy of intraperitonealbevacizumab plus chemotherapy in ovarian cancer ascites is superior tointraperitoneal chemotherapy alone, All adverse effects were controllable. The concentration of VEGF in ovarian cancer ascites can be used as predictors ofintraperitoneal injection bevacizumab treatment and indicators for monitoring ofthe treatment efficacy. The concentration of CA125in ascites can be used asindicators for monitoring the treatment efficacy.