title: Epithelial ovarian cancer: definitive radiotherapy for limited recurrence after complete remission had been achieved with aggressive front-line therapy.
abstract: The purpose of this study was to assess the efficacy and toxicity of definitive radiotherapy (RT) for the recurrence of epithelial ovarian cancer, which is limited to one or two gross regions, after complete remission had been achieved with aggressive front-line therapy. Twenty-seven patients were treated with definitive RT and were retrospectively analyzed. Their median tumor size was 3.0 cm. Twenty-six (96%) patients received external irradiation at a median total dose of 60 Gy, and a median daily dose of 2 Gy. Only two patients received intracavitary brachytherapy. Twenty (74%) of the 27 patients received systemic chemotherapy for the treatment of a limited recurrent tumor followed by definitive RT. Six (22%) of the patients received concurrent chemotherapy and seven (26%) of the patients also underwent regional hyperthermia during definitive RT. Twenty-two (82%) patients had an objective response (CR: 11, PR: 11). The 2-year overall survival, progression-free survival and local (in-field) control rates after RT were 53%, 39% and 96%, respectively. The toxicities were mild, no Grade 3 or higher toxicity was observed in any of the patients. The tumor size( < 3 cm), period between front-line therapy and RT (≥2 year) and objective tumor response (CR) were significant prognostic factors of the overall survival rate. In conclusion, definitive RT for limited recurrence of epithelial ovarian cancer achieves a better local control rate without severe toxicity, and it may therefore be a potentially effective modality for inducing long-term survival in selected patients.
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Yahara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ohguri
authors.forename: Hajime
authors.initials: H
authors.lastname: Imada
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kawagoe
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsuura
authors.forename: Toru
authors.initials: T
authors.lastname: Hachisuga
authors.forename: Yukunori
authors.initials: Y
authors.lastname: Korogi
mesh_terms: D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D009375:Neoplasms, Glandular and Epithelial / Q000532:radiotherapy*; D010051:Ovarian Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D012074:Remission Induction / Q000379:methods; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome