Clinical Research Of Neoadjuvant Chemotherapy On Advanced Epithelial Ovarian Cancer

Objective : To investigate the clinical significance of neoadjuvant chemotherapy ( NACT ) on advanced epithelial ovarian cancer.Methods : Retrospective analysis of 161 patients with advanced epithelial ovarian cancer (FIGOⅢ-Ⅳ) of Sichuan province tumor hospital from 1999.1-2008.12.were performed.Of these patients,73 cases were treated with neoadjuvant chemotherapy and interval debuking surgery and chemotherapy (research group),while other 88 cases were underwent primary cytoreductive surgery and chemotherapy (traditional group). All the cases were followed by platinum-based chemotherapy after surgery.Results : The rate of optimal surgical resection in research group and traditional group was 77.1% and 56.8% respectively .There was a significant difference between the two groups(Table 2 , P=0.120).There was a significant difference between two groups with intraoperative blood loss ,blood transfusion ,fluid transfusion , ascites volume, time of surgery. (P<0.05)The PFS (progression-free surial) and OS (overall surial) were 22.7months ( 7-63.5months ) and 33.5months(13.8-92.3months)in research group,while the PFS and OS in traditional group were 21.7months ( 4.3-61.2months ) and 32.1months ( 12.4-114.9months )。There was no significant difference between two groups in PFS and OS. (P=0.082 and P=0.293, respectively). Five year survival rate of two gourps were 17.8% and 11.4% in research group and raditional group, respectively without significant difference. (P=0.503).Conclusion: Although the study of PFS and OS and the traditional mode of surgery plus chemotherapy group compared with results not significantly different, but the research group (NACT and surgery and chemotherapy) was able to obviously enhance tumor resection rate, decrease blood loss, while no increase in operative complications, that NACT group than the surgery can be achieved in terms of conventional treatment. In order to improve the PFS of patients with OS, yet to be post-operative chemotherapy, including the search for new means of chemotherapy and chemotherapy. Therefore, NACT and surgery and chemotherapy for ovarian cancer is worthy of further prospective randomized clinical study to clarify its clinical value. Objective : Epithelial ovarian cancer is the highest mortality of gynecological malignancies, commonly used in clinical treatment is the ideal first cytoreductive surgery and postoperative combined with cisplatin + paclitaxel-based systemic chemotherapy. For unresectable advanced ovarian cancer, neoadjuvant chemotherapy can reduce tumor burden and improve the thoroughness of surgery, is a new therapeutic strategy. This review of neoadjuvant chemotherapy in the treatment of advanced ovarian cancer, the purpose of case selection criteria, preoperative neoadjuvant chemotherapy choose assessment method, chemotherapy, medications, route of administration, efficacy evaluation, and clinical value, in order to provide a useful clinical practice Evidence.