Addition of bevacizumab to neoadjuvant chemotherapy for Stage IV ovarian serous adenocarcinoma with multiple lymph node metastases: a case report.

A 50-year-old female patient was diagnosed with Stage IV ovarian serous adenocarcinoma with multiple lymph node metastases. The CA-125 level normalized after four cycles of neoadjuvant chemotherapy (NACT) using paclitaxel, nedaplatin, and bevacizumab (BEV) before surgery. A positron emission tomography-computed tomography (PET-CT) scan showed significantly reduced bilateral adnexal masses after NACT fluorodeoxyglucose (FDG) metabolism in multiple lymph nodes was inhibited significantly, and the number and sites of metastatic lesions were decreased. The patient underwent optimal cytoreductive surgery. Chemotherapy was continued after surgery and image-guided radiation therapy (IGRT) (40 Gy) was applied for the remaining lymph nodes in the pelvic cavity and cervicothoracic region. No sign of recurrence has been observed in this patient nine months after surgery. The patient achieved a satisfactory outcome and no serious side effects were observed. Therefore, addition of BEV to NACT is a new method for the pre-operative treatment of advanced ovarian cancer.