The purpose of this study was to evaluate the clinical efficacy of differentiated treatment of ovarian cancer. A study conducted on the basis of OOD (Odessa) during 2012–2016 conducted a comparative analysis of the results of treatment of 350 patients with stage III–IV stage, which performed suboptimal or non-optimal cytoreductive surgery.
To assess the quality of life and study the relationship between changes in physical health and quality of life, patients of both groups were asked to complete the questionnaire EORTC QLQ-C30. Patients in the first and second groups filled the questionnaire EORTC QLQ-C30 simultaneously over the same period of time, corresponding to two courses of monochemotherapy.
All patients were additionally questioned using the Russian-language version of the SF-36 questionnaire at the beginning of treatment and after the completion of treatment. The term of follow-up observation was 36 months.
The determination of the probability of differences between the groups 2 criterion, taking into account the compared was performed using the Yates correction for pair comparisons and Bonferoni corrections for multiple comparisons with the control group. Statistical processing was performed using the STATISTICA 10.0 software (StatSoftInc., USA).
In the control group, after complete treatment, 38.0% cases achieved complete regression, however, in 10% of cases, subtotal (more than 50%) and 1.1% were incomplete (less than 50%). For comparison — among platinum-sensitive women, complete reduction was achieved in 70% of cases. Attention is paid to the slightly lower frequency of complete regression in platinum-resistant and platinum-refractory cases of ovarian cancer — 37% and 39% respectively.
Objective effect from the treatment at the prospective stage was observed in all patients with RH, stabilization of the patient’s condition was 96.0% in the control group, with undifferentiated treatment, 96.1% — in platinum-resistant patients, 99.0% in platinum-refractory patients and 100% — platinum-sensitive patients. Under the control of the disease understand the combination of the objective effect and stabilization of the course of the disease for 6 months or more. It was achieved in 90% of the control group, 96.1% in cases of platinum resistance, 99.0% in cases of platinum refractory, and in all patients with platinum-susceptible forms of cancer.
The platinum resistance rate when applying the proposed prognostic model is 55.0%. The introduction of pathogenetically-based schemes of complex medical therapy, taking into account the degree of platinum resistance, allowed to significantly lengthening the survival time of patients with ovarian cancer. In particular, overall survival in the 2nd subgroup of Group I increased to 33.1±1.4 months, and in the 3rd subgroup — to 36.8±1.9 months. The use of HIPEC technology allows you to increase the overall survival rate to 33.1±1.4 months, DFS — 17.2±1.6 months, FFTF — 17.0±1.6 months, EFS — 16.8±0.9 months, and PFS is 16.9±0.8 months. Thus, the use of HІPEC has allowed us to significantly improve the results of treatment. When evaluating the patients’ liver on the scale of the questionnaire SF-36 found that the positive effect of differentiated therapy is maintained up to 3 years.