Results of post-operative abdomino-pelvic radiotherapy in intermediate- and high-risk epithelial ovarian carcinoma.
To review the outcome of successive surgery, chemotherapy and abdomino-pelvic radiotherapy in ovarian cancer; 212 patients who had been treated with surgery, chemotherapy, and APRT, during 10 years were studied. The patients ranged in age from 23 to 76 years (median 53). International Federation of Gynecology and Obstetrics staging showed 32 patients in stage Ic, 57 in stage II and 123 in stage III. Serous carcinoma was the most frequent type. Most of the patients had grade 1 histology. The majority had undergone optimal cytoreductive surgery. They were put on platinum-based chemotherapy and got APRT. Chemotherapy was started before, after or three courses before and three after radiation. Radiotherapy was delivered using Cobalt-60 anterior posterior fields to encompass the peritoneal cavity. They received at least 2000 cGy to abdomen and 5000 cGy to the pelvis. Minimum follow-up was 60 months. The result showed that most of the patients experienced RTOG grade 1 or 2 acute toxicities that responded to medication. Late complications were reasonable (3.8%), mostly were managed conservatively. Unplanned radiation interruptions were necessary in 42 patients (20%). Stage, grade and histology affected survival. Failure sites were abdomen in 35 cases, pelvis in 34, both pelvis and abdomen in 19 and distant metastasis in 34 cases. Overall, five-ear survival was 84.4%, 65%, 21% in stages Ic, II, III, respectively. We came to the conclusion that: Abdomino-pelvic radiotherapy is a safe adjuvant treatment in ovarian cancer and is well tolerated by most patients. Abdomino-pelvic radiotherapy does not significantly increase treatment complications in ovarian cancer. Radiation should be concerned in patients with high probability of recurrence of epithelial ovarian tumours.
Shiraz Institute for Cancer Research, Shiraz University of Medical Science, Shiraz, Iran. mosalaa@sums.ac.ir
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Mosalaei
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Kazerooni
D000005:Abdomen / Q000528:radiation effects*; D000328:Adult; D000368:Aged; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality / Q000532:radiotherapy* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000628:therapy; D010388:Pelvis / Q000528:radiation effects; D011832:Radiation Injuries / Q000209:etiology* / Q000401:mortality; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome