A Preliminary Study On The Efficacy Of Bevacizumab Combined With Chemotherapy In The Treatment Of Malignant Abdominaladhesions

Objective:To investigate the clinical efficacy of intraperitoneal injection of bevacizumab and carboplatin combined with paclitaxel intravenous chemotherapy in the treatment of malignant abdominal adhesions,and to observe the effect of bevacizumab on the drug concentration after intraperitoneal perfusion of carboplatin.Methods:A total of 28 patients with pathologically confirmed ovarian cancer and peritoneal adhesions were selected,who were hospitalized in our department from March 2016 to March 2017.According to SPSS22.0 software random numbers generated were randomly divided into two groups according to the ratio of 1:1.On the basis of treatment of Paclitaxel 175mg/m2 in both two groups,Group A(control group)received intraperitoneal injection of carboplatin AUC 5 alone,group B(test group)received intraperitoneal injection of carboplatin AUC 5 and bevacizumab 5 mg/kg.After two cycles of treatment,the changes of clinical symptoms,the improvement of peritoneal adhesions,the changes of VEGF in abdominal cavity,the adverse reactions of chemotherapy drugs and the pharmacokinetics of carboplatin were observed.The curative effect of the two groups on abdominal adhesion was compared.Result:There was no significant difference in baseline level between the two groups before treatment.The clinical remission rate of test group was significantly higher than that of the control group(85.71%vs 41.67%,P<0.05).After treatment,the level of VEGF in test group was significantly lower than that in control group(139.89 ± 10.89ng/mL vs 81.57 ± 4.71 ng/mL,P<0.05).No serious adverse reactions were seen in both groups.Among them,the observed incidence of hypertension was significantly higher than the control group(71.4%vs 0,P<0.05).There was no statistically significant difference in the other incidences between the two groups,such as neutropenia(75%vs 57.1%),thrombocytopenia(66.7%vs 64.3%),nausea and vomiting(33.3%vs 28.6%),diarrhea(25%vs 14.3%)and epistaxis(66.7%vs 57.1%).Carboplatin was eliminated in the abdominal cavity by a two-compartment model.The area under the plasma concentration-time curve(AUC)in the test group was significantly higher than that in the control group(98.19h*ug/mL vs 69.30h*ug/mL,P<0.05).Conclusion:The intraperitoneal administration of bevacizumab with carboplatin can reduce the clinical symptoms of ovarian cancer with intraperitoneal adhesions without causing serious side effects.The bioavailability of carboplatin in the experimental group was significantly higher than that of the control group.Peritoneal infusion combined with bevacizumab increased the concentration of carboplatin in the abdominal cavity,prolonged the action time of carboplatin in the abdominal cavity,and improved the therapeutic efficacy.Bevacizumab combined with chemotherapy has important clinical application value in the treatment of cancerous abdominal adhesions.