Limited-field radiotherapy as salvage treatment of localized persistent or recurrent epithelial ovarian cancer.
Thirty-five patients with persistent or recurrent epithelial ovarian cancer were treated with salvage pelvic or para-aortic radiotherapy for disease limited to the pelvis (29), para-aortic retroperitoneum (5), or vaginal cuff (1). Prior therapy included a median of 3 chemotherapeutic drugs (range, 1-7) over a median of 12 cycles (range, 5-39); 12 patients had received intraperitoneal chemotherapy. The median number of prior laparotomies was 3 (range, 2-5). Including pelvic boosts, the median dose delivered to the treatment field was 4600 cGy (range 4000-7000); 2 patients received additional treatment with a permanent 125I implant. All patients completed therapy, although 5 (14%) with grade 3 toxicity required a treatment break. Late bowel complications unrelated to recurrence occurred in 3 patients (9%). Median actuarial and progression-free survivals for all patients from start of radiotherapy were 40 and 14 months, respectively. At least 16 of 26 (62%) recurrences involved the treatment field. Multiple prognostic factors were evaluated in terms of recurrence, survival, and acute and chronic complications, but no significant prognosticators were detected. These findings indicate that limited-field salvage radiotherapy has an acceptable complication rate and may prolong the symptom-free survival interval in selected patients.
Davidson
S A
SA
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
Rubin
S C
SC
Mychalczak
B
B
Saigo
P E
PE
Lewis
J L
JL
Chapman
D
D
Hoskins
W J
WJ
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D010220:Para-Aortic Bodies / Q000528:radiation effects; D010388:Pelvis / Q000528:radiation effects; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate
D000970:Antineoplastic Agents