Abstract:

Objective To study the efficacy and safety of intraperitoneal injection bevacizumab combined with intraperitoneal hyperthermic perfusion chemotherapy in treatment of malignant ascites of ovarian cancer. To analyze the clinical significance of the concentration change of vascular endothelial growth factor（VEGF） in ascites in treatment of intraperitoneal injection bevacizumab. Methods Forty-six patients with malignant ascites of ovarian cancer were randomly divided into treatment group（n=25） and control group（n=21）. All patients were treated with TC chemotherapy（paclitaxel 135mg／m2，iv d1+carboplatin AUC=5， iv d1）， repeated every 3 weeks for 6 weeks， and with intraperitoneal hyperthermic perfusion chemotherapy combined with intraperitoneal cisplatin 40mg／m2，repeated every 2 weeks for 6 weeks. The treatment group were accepted intraperitoneal injection with bevacizumab（avastin） 300mg after each intraperitoneal hyperthermic perfusion chemotherapy for 6 weeks. The improvement of life quality， curative effect and adverse reaction were evaluated. The concentration of VEGF of ascites of two groups were assayed by ELISA method before and after treatment. Results After treatment， the concentration of VEGF in ascites of treatment group was（468.30±42.80）pg/ml, which was lower than that of treatment group before treatment（P＜0.05）, which was decreased significantly compared with that of control group（P＜0.05）. The total effective rate of the treatment group was 92.0％， which was higher than 61.9％ of the control group. There were significant differences in two groups（P＜0.05）. In the treatment group, the effective rate in VEGFpositive patients was 100.0%, and it was 50.0% in VEGFnegative patients（P＜0.05）. The improvement rate of quality of life（QOL） was 92.0％ in treatment group， while it was 57.1％ in control group， which had significant difference between two groups（P＜0.05）. All the patients were of good tolerance in whole therapy and no severe side effects occured. Conclusion The treatment of malignant ascites of ovarian cancer with intraperitoneal injection bevacizumab combined with intraperitoneal hyperthermic perfusion chemotherapy is effective and safety, especially to VEGFpositive patients with ovarian cancer ascites.