From Diagnosis to Hope: Navigating Treatment and Emerging Stronger

In June 2017, a 66-year-old woman in Sichuan, China, sought medical attention for persistent abdominal distension lasting over six months. Medical tests, including ascites cytology and a CT scan, confirmed ovarian adenocarcinoma (FIGO Stage IIIC) with bilateral adnexal masses and multiple retroperitoneal lymph nodes. Her CA-125 level was significantly elevated at 698.20 U/ml.

The patient opted against surgery and began six cycles of chemotherapy (paclitaxel + carboplatin). After treatment, scans confirmed a complete response (CR), with no detectable disease. However, she declined further surgical intervention and continued observation.

In February 2020, she returned with vaginal bleeding. Imaging revealed a new pelvic mass (10.3×6.3×8.2 cm), and CA-125 levels exceeded 1000 U/ml. The oncologist classified it as a platinum-sensitive recurrence, leading to another six cycles of chemotherapy, resulting in a partial response (PR).

By May 2021, the tumor recurred in the same location, growing to 12.2×7.9×10.0 cm. CA-125 rose to 560.05 U/ml. Despite one cycle of chemotherapy, CA-125 increased further, and imaging confirmed disease progression. The oncologist switched to bevacizumab-based targeted therapy, followed by combination chemotherapy, stabilizing the disease temporarily.

By July 2022, the patient’s condition worsened, with a pelvic mass (12.5×10.6 cm) and CA-125 at 1175.16 U/ml. After multiple chemotherapy cycles with poor response, the oncologist proposed radiotherapy combined with immunotherapy (PD-1 inhibitor tirilizumab). She began treatment in November 2022, experiencing minimal side effects.

As of June 2023, abdominal CT scans show tumor shrinkage, and CA-125 has dropped to 18.30 U/ml. The patient continues immunotherapy maintenance with stable disease, demonstrating the potential of targeted and immunotherapy approaches in recurrent ovarian cancer..