Postoperative whole abdominal radiotherapy in clear cell adenocarcinoma of the ovary.
OBJECTIVE
The aim of this study was to clarify the efficacy of postoperative whole abdominal radiotherapy (WAR) for ovarian clear cell adenocarcinoma (OCCA).


METHODS
Between 1996 and 2004, 16 patients with OCCA underwent initial debulking surgery and received postoperative WAR. Indications for WAR were as follows: OCCA, International Federation of Gynaecology and Obstetrics (FIGO) stage Ic-III, no macroscopic residual disease in the upper abdomen and residual disease in the pelvic cavity < or = 2 cm. The planned WAR comprised external beam radiotherapy (EBRT) to the entire abdominal cavity with 22.0-24.0 Gy/22-24 fractions followed by EBRT to the pelvis with 23.4-21.6 Gy/12-13 fractions. Overall survival (OS) and disease-free survival (DFS) were compared with 12 historical control (HC) patients treated with initial debulking surgery followed by platinum-based chemotherapy.


RESULTS
The FIGO stage in the WAR group was stage Ic in 11 patients, stage II in 3, and stage III in 2. Fifteen of the 16 patients (94%) completed the planned WAR. Two patients developed radiation enterocolitis and required bowel surgery. Five-year OS and DFS in the WAR/HC group were 81.8%/33.3% and 81.2%/25.0% (p=0.031 and p=0.006), respectively.


CONCLUSIONS
This study suggests that postoperative WAR may be effective in selected patients with OCCA. Prospective randomized trials should be considered to assess postoperative WAR for OCCA.
Nagai
Yutaka
Y
Department of Obstetrics and Gynecology, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan. ynagai@med.u-ryukyu.ac.jp
Inamine
Morihiko
M
Hirakawa
Makoto
M
Kamiyama
Kazuya
K
Ogawa
Kazuhiko
K
Toita
Takafumi
T
Murayama
Sadayuki
S
Aoki
Yoichi
Y
D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D011182:Postoperative Care; D011878:Radiotherapy / Q000009:adverse effects
D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin