The Efficacy And Safety Of Bevacizumab In Combination With Chemotherapy For Treatment Of Recurrent Epithelial Ovarian Cancer:a Systematic Review

Background and purpose:Epithelial ovarian cancer is one of the female reproductive system tumorsinvolving high mortality and lack of reliable methods for early clinical diagnosis.Even if those patients have received optimal cytoreductive surgery and standardchemotherapy followed, their relapse are not uncommon. The treatment for recurrentepithelial ovarian would be more difficult, and no effective ways till now (However,no effective treating guidelines for recurrent epithelial ovarian were in practise tillnow). It is particularly important to explore the treatment for it. The current studycollected published essays about bevacinumab combining with chemotherapy fortreatment of recurrent epithelial ovarian cancer aiming to assess their efficacy andsafety of by meta-analysis.MethodsWe search Pubmed, EMbase, Cochrane Library, Web Science, CNKI, CBM, VIPand Wanfang databases, and manually search Chinese Journal of Obstetrics andGynecology, Progress in Obstetrics and Gynecology, International Obstetrics andGynecology, Practical Obstetrics and Gynecology. All the literature publishedbetween the database built to December2014. Select the literature according to theinclusion criteria and exclusion criteria set before. Every data in the literature will beextracted and divided into two groups: bevacizumab plus chemotherapy group and thechemotherapy group. Finally, there are3articles selected, a total of909patients.The meta-analysis was performed using Revman5.3software to get the forest plots ofprogression-free survival, overall survival and the adverse effects.Result:1. There were significantly difference in progression free survival and nodifference in overall survival between the two groups. Bevacizumab in combination with chemotherapy (experimental group) can prolong progression free survival ofpatients with recurrent epithelial ovarian cancer[P <0.00001, HR=0.48,95%CI(0.41,0.56)]. In terms of improving overall survival was not statistically significant [P=0.48>0.05, HR=0.94,95%CI (0.78,1.12)]. Increase the risk of hypertension [P=0.03<0.05, RR=10.45,95%CI (1.22,89.82)], proteinuria [P=0.0007, RR=9.35,95%CI (2.57,34.10)], arterial thrombosis [P=0.03<0.05, RR=4.43,95%CI(1.14,17.19)], bleeding [P=0.007, RR=3.59,95%CI (1.41,9.16)] of recurrentovarian cancer patients, does not increase the risk of neutropenia [P=0.73>0.05, RR=0.94,95%CI (0.68,1.31)], intestinal perforation [P=0.14>0.05, RR=9.10,95%CI (0.49,167.79)], intestinal abscess and fistula [P=0.32>0.05, RR=2.31,95%CI(0.44,12.07)], congestive heart failure [P=0.74>0.05, RR=1.28,95%CI(0.29,5.71)], venous thrombosis [P=0.81>0.05, RR=0.92,95%CI (0.48,1.77)],RPLS [P=0.15>0.05, RR=4.85,95%CI (0.56,41.63)], wound healingcomplications [P=0.32>0.05, RR=4.72,95%CI (0.23,97.75)] of patients withrecurrent ovarian cancer,.Conclusion:1. bevacizumab in combination with chemotherapy versus chemotherapy alonegroup, the meta-analysis showed that: the addition of bevacizumab for recurrentovarian cancer may prolong progression free survival in patients, however, there is nosignificant difference for the overall survival.2.The meta-analysis showed that: the addition of bevacizumab could increase therisk of high blood pressure, proteinuria, arterial thrombosis, bleeding in recurrentovarian cancer patients, but not increase the risk of neutropenia, intestinal perforation,intestinal abscess and fistula, congestive heart failure, venous thrombosis, RPLS,wound healing complications in recurrent ovarian cancer patients.