The estimation criteria of the platinum - based chemotherapy effectiveness

Abstract

The problem of diagnosing and treating ovarian malignancies is one of the most challenging issues in oncology and gynecology. The number of new cases of ovarian cancer in the world, according to previous years, per year is 295414 (6.6% of all forms of cancer in women). Mortality from ovarian cancer in the world is 184799 cases (3.9% in the structure of cancer mortality in women). There has been a steady increase in the incidence in recent years, as well as a high percentage of patients with III–IV disease stages. The majority of patients with ovarian cancer are diagnosed at late stages, and treatment results remain disappointing. Despite the high sensitivity of many modern diagnostic methods, their specificity is insufficient to differentiate between benign and malignant processes in the ovaries. The main principle of treatment of all tumors of ovarian origin is the implementation of surgical interventions, which are the most complete removal of tumor nodes, in combination with the use of chemotherapeutics at different stages. At the revealed recurrences of a disease it is also accepted to consider as an optimum variant of the further tactics of appointment of courses of chemotherapeutic treatment. The aim of the work is to assess the quality of life in platinum-resistant patients with ovarian cancer, depending on the degree of pharmacoresistance and differentiated use of chemotherapy. Materials and methods. The presented study was conducted on the basis of oncology department of the University Clinic of the Odessa National Medical University during 2014 – 2020 years. 350 patients with adenocarcinoma of the ovaries of III–IV stage were examined, who performed cytoreductive operations. Additionally, QL was determined using standard questionnaires EORTC QLQ-C30 and FACT-G. Results and discussion. It is shown that the initial values on the subscales of the questionnaires EORTC QLQC30 and FACT-G in patients classified as different clinical groups were compared. When using a differentiated approach in the treatment of patients with ovarian cancer, the indicators on the scales of physical (PF), role (RF) and emotional functioning (EF) were significantly improved. In addition, the intensity of nausea (NV) and general weakness (FA) decreased in patients of groups III and IV. In the case of differentiated use of chemotherapeutic agents with metabolic support, the total score according to the FACT-G questionnaire was 77.8±0.9 points in group III, and 77.9±0.8 points in group IV, which significantly exceeds the received in I and II groups – 72.2±1,2 and 71,60,9 points. The described differences were kept throughout the period of catamnestic observation. Conclusions. The use of a differentiated approach in the treatment of patients with RI significantly improved indicators on the scales of physical (PF), role (RF) and emotional functioning (EF). After treatment, the intensity of nausea (NV) and general weakness (FA) decreased in patients of groups III and IV. The described differences were retained for 12 months after the completion of the course of treatment. Prospects for further research are related to the study of the dynamics of life quality of patients with ovarian cancer at the subsequent stages of catamnestic observation. We see the prospect of further research in improving modern approaches to the treatment of advanced ovarian cancer and assessing patient survival rates as a marker of the effectiveness of a personalised approach.