Shimizu Yusuke, Kajiyama Hiroaki, Yoshida Kosuke, Tamauchi Satoshi, Nakanishi Toru, Kikkawa Fumitaka
Department of Gynecologic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
J Obstet Gynaecol Res. 2019 Dec;45(12):2435-2439. doi: 10.1111/jog.14112. Epub 2019 Aug 29.
Accumulation of ascites fluid is a major obstacle in the late phase of epithelial ovarian cancer. However, there is no consensus on a specific treatment for malignant ascites. The present study evaluated the clinical benefit of half-dose bevacizumab therapy (7.5 mg/kg every 3-4 weeks).
This was a single-arm interventional study performed at Aichi Cancer Center Hospital. Four patients with platinum-resistant epithelial ovarian cancer and symptomatic malignant ascites were no longer considered candidates for standard chemotherapy. As a palliative approach, half-dose bevacizumab therapy (7.5 mg/kg every 3-4 weeks) was used with informed consent. The clinical data of these patients were retrospectively reviewed.
All patients had been heavily pretreated and showed progressive disease. Thus, standard chemotherapy was no longer feasible, and palliative paracentesis for malignant ascites was clinically needed. Among the four patients, three did not require additional paracentesis after bevacizumab therapy, and there were no adverse events. One patient needed paracentesis owing to lymphorrhea.
The use of bevacizumab therapy as a palliative approach for malignant ascites might be an option in patients with terminal-stage ovarian cancer. However, further evaluation is needed with regard to the possibility of severe side effects and medical expenses.
腹水积聚是上皮性卵巢癌晚期的主要障碍。然而，对于恶性腹水的具体治疗方法尚无共识。本研究评估了半量贝伐单抗治疗（每3 - 4周7.5mg/kg）的临床疗效。
这是一项在爱知癌症中心医院进行的单臂干预性研究。4例铂耐药上皮性卵巢癌且有症状性恶性腹水的患者不再被视为标准化疗的候选者。作为一种姑息治疗方法，在获得知情同意后使用半量贝伐单抗治疗（每3 - 4周7.5mg/kg）。对这些患者的临床资料进行回顾性分析。
所有患者均经过大量前期治疗且疾病进展。因此，标准化疗不再可行，临床上需要对恶性腹水进行姑息性腹腔穿刺引流。4例患者中，3例在接受贝伐单抗治疗后无需额外进行腹腔穿刺引流，且无不良事件发生。1例患者因淋巴漏需要进行腹腔穿刺引流。
对于晚期卵巢癌患者，使用贝伐单抗治疗作为恶性腹水的姑息治疗方法可能是一种选择。然而，需要进一步评估严重副作用的可能性和医疗费用。
