Purpose of the study. To evaluate the effectiveness of the targeted drug bevacizumab (Avegra®) in the complex treatment of patients with common forms of ovarian cancer after suboptimal cytoreductive surgical interventions. Materials and methods. For the period from January 2017 to November 2018. A clinical study included and treated 71 patients with a diagnosis of ovarian cancer, stage IIIC-IV disease. The prevalence of the tumor process was estimated according to the classification of FIGO and TNM (2009). Patients were randomized into two groups. The first group included 31 patients, the treatment was carried out according to the scheme: paclitaxel 175 mg/m2, carboplatin AUC 6, bevacizumab 15 mg/kg with an interval of 21 days. The second group (control group) included 40 patients who received standard drug therapy. Interval suboptimal cytoreductive surgery was performed in all patients - hysterectomy with appendages, epiploic resection, peritonectomy. Evaluation of the effectiveness of immediate and remote The results were carried out by the method of statistical processing using the program Statistic 6.0. Results. According to the criteria of RESIST 1.1 in the first group, a complete response was registered in 25.8%, a partial response in 51.6%, stabilization of the disease in 12.9%, progression of 9.6% of cases. In the second group, the complete response was in 20% of cases, a partial response was 45%, stabilization was 22.5%, progression was 12.5%. The median overall survival in the first group was 16.5 months аgainst 10.1 months in the second group.
Aim. To study the relationship between the symptoms of nutritional insufficiency and systemic inflammation in cancer palliative patients. Methods. 106 palliative cancer patients were examined at Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine: 54 (50.9%) men and 52 (49.1%) women aged 61 [54; 67] years. All patients underwent laboratory and instrumental examination within the approved standards of specialized medical care. Systemic inflammation was assessed by the levels of acute phase proteins (C-reactive protein, fibrinogen). The study of integrated clinical and laboratory, somatometric parameters was carried out. The nutritional risk index was assessed. Results. Palliative cancer patients showed a statistically significant decrease in the concentration of hemoglobin, lymphocytes, and albumin. The activation of systemic inflammation that manifested by hyperfibrinogenemia and an increase in the level of C-reactive protein was revealed. The study of somatometric parameters revealed a statistically significant decrease in body mass index, shoulder circumference, subscapular skinfold thickness, and a tendency to reduce lean body mass. The nutritional risk index assessment showed mild nutritional insufficiency in 22 (20.8%) of the examined patients and severe nutritional insufficiency in 28 (26.4%) patients. The maximum diagnostic significance of the level of C-reactive protein for prediction the nutritional insufficiency was achieved at 80.4% sensitivity and 52.7% specificity (AUC=0.671, 95% confidence interval [0.573; 0.759], p=0.001), which corresponded to a C-reactive protein threshold of 31 mg/l. Conclusion. 50 (47.2%) of the examined patients showed signs of nutritional insufficiency, a statistically significant decrease in hemoglobin and albumin concentration, as well as lymphocyte count, activation of systemic inflammation, manifested by hyperfibrinogenemia, and an increase in the level of C-reactive protein; it was revealed a statistically significant relationship between C-reactive protein level and malnutrition.
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