title: Long-term Benefit of Tumor Volume-Directed Involved Field Radiation Therapy in the Management of Recurrent Ovarian Cancer.
abstract: OBJECTIVE
  This study aimed to report on long-term effectiveness of involved field radiation therapy (IFRT) in the salvage of localized recurrent ovarian cancer (ROC).
  
  
  METHODS
  A retrospective analysis of 27 patients with a diagnosis of epithelial ovarian cancer who received tumor volume-directed IFRT for localized extraperitoneal recurrences (either as consolidation after cytoreductive surgery (CRS) or as attempted salvage if unresectable) forms the basis of this report. All patients were heavily pretreated with multiple chemotherapy regimens. Involved field radiation therapy was primarily with external beam (median dose, 50.4 Gy). Local recurrence-free survival (LRFS) was defined as freedom from in-field recurrences and was considered as a measure of effectiveness of radiotherapy. Statistical analyses evaluated association between disease-free survival, overall survival, LRFS, and various prognostic factors. Comparison was also made with a similar but unmatched cohort with localized recurrences salvaged by additional chemotherapy instead of local therapies (NIFRT group).
  
  
  RESULTS
  Of 27 patients, 17 had optimal CRS before RT. The actuarial survival at 5 and 10 years (in parenthesis) from date of radiation were LRFS (70% and 60%), overall survival (30% and 19%), and disease-free survival (33% and 20%). None of the NIFRT patients survived beyond 5 years from initiation of salvage chemotherapy.
  
  
  CONCLUSIONS
  Long-term follow-up in this selected series confirmed the benefit of IFRT (±CRS) in localized ROC. Chemotherapy salvage in a similar NIFRT group was not equivalent, suggesting a role for locoregional therapies in selected patients with ROC.
authors.affiliation: *Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL; †University of Texas Southwestern Medical Center, Moncrief Radiation Oncology Center, Dallas, TX; Departments of ‡Anesthesiology, and §Gynecologic Oncology, Loyola University Medical Center, Maywood, IL; and ||Massachusetts Eye and Ear Infirmary, Biostatistics Core, Harvard Medical School, Boston, MA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Albuquerque
authors.forename: Mona
authors.initials: M
authors.lastname: Patel
authors.forename: Margaret
authors.initials: M
authors.lastname: Liotta
authors.forename: Matthew
authors.initials: M
authors.lastname: Harkenrider
authors.forename: Rong
authors.initials: R
authors.lastname: Guo
authors.forename: William
authors.initials: W
authors.lastname: Small
authors.forename: Potkul
authors.initials: P
authors.lastname: Ronald
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000532:radiotherapy*; D019468:Disease Management; D016889:Endometrial Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden