I. Brief Introduction of the Condition#
- Female, 76 years old, discovered a large pelvic mass 6 years ago, sought medical attention for abdominal distension.
- Pathological puncture confirmed ovarian cancer with multiple abdominal metastases and a large amount of ascites.
II. Treatment Process#
- Not suitable for surgery at the moment, chemotherapy was initiated first.
- Carboplatin and paclitaxel-based chemotherapy for 5 cycles, each cycle lasting 21 days.
- After chemotherapy, maintenance with oral olaparib twice a day for 5 years.
- Monthly CA125 tests during this period, with enhanced CT scans every six months.
III. Treatment for Recurrence#
- CT in April 2024 indicated recurrence, with abnormal elevation of CA125.
- Continued with carboplatin, paclitaxel, and bevacizumab chemotherapy for 4 cycles.
- During the 5th cycle, allergic reaction to carboplatin occurred, leading to a pause in carboplatin chemotherapy (this is a hidden risk).
- In the 6th and 7th cycles, although carboplatin was replaced with cisplatin for continued chemotherapy, CA125 continued to rise.
- Chemotherapy ended in August 2024, continued oral olaparib, but CA125 still continued to rise.
- On New Year's Day 2025, olaparib was stopped, and an attempt was made to maintain with oral letrozole.
- In April 2025, an attempt was made to add niraparib for maintenance, with CA125 exceeding 1000.
IV. Current Dilemma#
- General physical condition is average, RBC 3.0, HB 97, PLT 104.
- Recently experienced irregular lower gastrointestinal bleeding, with a significant amount on May 24.
- Economic condition is average; what treatment plan should be used moving forward?
- Is abdominal hyperthermic perfusion therapy possible?
- If hyperthermic perfusion is possible, will cisplatin be ineffective like in the 6th and 7th cycle of chemotherapy?
- Seeking guidance from industry experts.