Published online Jun 27, 2023. doi: 10.4240/wjgs.v15.i6.1149
Peer-review started: March 8, 2023
First decision: March 15, 2023
Revised: March 18, 2023
Accepted: April 14, 2023
Article in press: April 14, 2023
Published online: June 27, 2023
Processing time: 99 Days and 8.4 Hours
Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy is its standard treatment. But for systemic chemotherapy of advanced pseudomyxoma peritonei (PMP), there are currently few studies and insufficient evidence.
Regimens for colorectal cancer are often used clinically, but there is no uniform standard for late-stage treatment.
The purpose of this single-center, retrospective study was to determine if bevacizumab combined with cyclophosphamide and oxaliplatin (Bev+CTX+OXA) is effective for treatment of advanced PMP.
Retrospective analysis was conducted on the clinical data of patients with advanced PMP who received Bev+CTX+OXA regimen from December 2015 to December 2020. Objective response rate (ORR), disease control rate (DCR) and incidence of adverse events were evaluated. Progression-free survival (PFS) was followed up.
A total of 32 patients were enrolled, after 2 cycles, ORR and DCR were 3.1% and 93.7% respectively. The median follow-up time was 7.5 mo. During the follow-up period, 14 patients (43.8%) had disease progression, and the median progression-free survival (PFS) was 8.9 mo. Stratified analysis showed that the PFS of patients with preoperative increase of CA125 (8.9 vs 2.1, P = 0.022) and completeness of cytoreduction score of 2-3 (8.9 vs 5.0, P = 0.043) were significantly longer than those of the control group. Multivariate analysis showed that preoperative increase of CA125 was an independent prognostic factor for PFS (HR = 0.245, 95%CI: 0.066-0.904, P = 0.035).
Bev+CTX+OXA regimen is certain effective in the posterior-line treatment of advanced PMP, and the adverse reactions can be tolerated. The preoperative increase of CA125 is an independent prognostic factor of PFS.
More sample size should be conduct in the future to validate the conclusion of our study.