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Objective:To investigate the clinical value and application of ATP based bioluminescence tumor chemo-sensitivity assay (ATP-TCA) in the chemotherapy for ascites caused by recurrent ovarian cancer.Methods:More than 10 kinds of chemotherapeutic drugs or combinations were applied and 35 ascites specimens from recurrent ovarian cancer were analyzed by ATP-TCA.Sensitivity of chemotherapeutic drugs was assessed.After 2-4 chemotherapeutic cycles,clinical outcomes were analyzed,which were compared with those of 40 cases by empirical regimens.Results:32 of 35 specimens were evaluated with an overall evaluation rate of 91%.The assay results suggested that chemo-naive patients responded to chemotherapeutic drugs with individualized profiles.The sensitivity rates of GEM,EPI,OXA,DDP,CBP,ADM,VP-16,CTX,NVB,5-FU,PTX and TXT were 40%,30%,33%,29%,33%,38%,25%,33%,38%,33%,25% and 20%,respectively.While the sensitivity rates of combinations GEM + EPI,GEM + CBP,GEM + DDP,NVB + DDP,CTX + ADM + DDP,CTX + ADM,DDP + VP-18,OXA + 5-FU,VP-16 + IFO,PTX + DDP,TXT + CBP,VCR + CTX + MTX,DDP + CPT-11,OXA + CPT-11,and DTIC + CTX were 47%,50%,36%,44%,30%,33%,27%,33%,40%,27%,23%,14%,28%,30% and 17%,respectively.In vitro results correlated well with clinical outcomes.Objective response rate (RR) in chemo-sensitivity-guided group was of significance compared with that in empirical-regimen-guided group.Conclusion:ATP-TCA is a choice for the screening of chemotherapeutic drugs against ascites caused by recurrent ovarian cancer with excellent sensitivity and reliability.ATP-TCA assay results correlate well with clinical outcomes,suggesting its clinical value in the management of difficult-to-manage therapeutic situations such as ascites in recurrent ovarian cancer.