Whole abdominal radiotherapy following cytoreductive surgery and chemotherapy in ovarian carcinoma.
Persistent or recurrent disease following surgery and chemotherapy in ovarian carcinoma remains a major therapeutic dilemma. Between January 1980 and December 1985, there were 26 patients who had previously undergone cytoreductive surgery and chemotherapy and were treated with external beam radiotherapy. Twenty-one of these patients had been treated with platinum-adriamycin-cytoxan (PAC) regimen and 5 were treated with other combinations. Surgical reevaluation was performed in 21 of the 26 patients and only 4/21 (19%) patients were free of disease. All 26 patients were irradiated with a planned dose of 2500 cGy/100 cGy/day or 2280 cGy/120 cGy/day to the whole abdomen and a final calculated dose to the pelvis of 4500 cGy. Initial evaluation showed a 3-year actuarial survival rate of 51% and a disease-free survival rate of 42%. Follow-up analysis yields survivals of 45 and 35%, respectively. Severe gastrointestinal complications were observed in 3/26 patients and all hematologic complications resolved. Variables of prognostic significance were chemotherapy tolerance, grade, and volume of residual disease. We conclude that a proportion of patients with disease following cytoreductive surgery and chemotherapy may be salvaged with abdominopelvic irradiation.
Kersh
C R
CR
Division of Therapeutic Radiology and Oncology, University of Virginia Medical Center, Charlottesville 22908.
Randall
M E
ME
Constable
W C
WC
Hahn
S S
SS
Taylor
P T
PT
Krebs
H B
HB
Goplerud
D R
DR
D000005:Abdomen; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009026:Mortality; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D011379:Prognosis; D013997:Time Factors
D000970:Antineoplastic Agents