Is there a place for whole abdominal radiotherapy in the management of ovarian cancer?
Most patients with ovarian cancer require further therapy with chemotherapy or radiotherapy because of the high recurrence risk following surgery alone. Radiotherapy directed to the whole abdomen and pelvis is capable of producing survival rates of 70% in carefully selected patients. Such patients have no more than microscopic residual disease in the abdomen, and small volume residual disease in the pelvis. They are selected based on a prognostic matrix which considers grade, stage and the presence of pelvic residual disease. With optimal radiotherapy technique, long term serious toxicity occurs in less than 5% of patients. Patients with macroscopic residual disease are treated with chemotherapy. Patients who obtain a complete response have been treated with consolidative whole abdominal radiotherapy, although the benefit of such an approach is unclear.
Morton
G C
GC
Department of Radiation Oncology, Toronto-Sunnybrook Regional Cancer Centre, North York, Ontario, Canada.
Thomas
G M
GM
D000005:Abdomen / Q000528:radiation effects*; D000008:Abdominal Neoplasms / Q000473:pathology; D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology; D010051:Ovarian Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018579:Patient Selection; D010386:Pelvic Neoplasms / Q000473:pathology; D010388:Pelvis / Q000528:radiation effects; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012074:Remission Induction; D012307:Risk Factors; D015996:Survival Rate