Abstract
<title>Abstract</title> <p> <bold>Background:</bold> Ovarian clear cell carcinoma (OCCC) is a distinct histological subtype of epithelial ovarian cancer. Its incidence is substantially higher in Asian populations than in Western populations. The clinical management of OCCC remains challenging, particularly in patients with advanced or recurrent disease, who generally have a poor prognosis. Advanced-stage OCCC shows intrinsic resistance to platinum-based chemotherapy and is associated with a very poor prognosis, while many questions regarding surgical and medical treatment remain unresolved. In this paper, we report the complete clinical case of a patient with platinum-refractory recurrent OCCC. <bold>Case presentation:</bold> The patient was 52 years old and had been diagnosed with 2014 International Federation of Gynecology and Obstetrics (FIGO) stage IC1 OCCC of the right ovary. The patient underwent comprehensive surgical staging followed by six cycles of first-line paclitaxel plus carboplatin chemotherapy. The disease recurred within 4 weeks after the final chemotherapy cycle and was therefore considered platinum-refractory. The patient subsequently received six cycles of gemcitabine monotherapy. Although a partial response was achieved after treatment for the first recurrence, the disease progressed again 7 months later. The patient then received involved-site radiotherapy (ISRT) delivered using intensity-modulated radiotherapy to a metastatic para-aortic lymph node in the retroperitoneum, followed by 2 years of anlotinib monotherapy. A partial response was achieved, and progression-free survival (PFS) exceeds 44 months. The disease remains stable at the latest follow-up. <bold>Conclusion:</bold> Sequential anlotinib maintenance therapy following local radiotherapy may represent a treatment option for patients with platinum-refractory OCCC presenting with localized recurrence or oligometastatic disease. </p>