title: Fractionated Palliative Pelvic Radiotherapy as an Effective Modality in the Management of Recurrent/Refractory Epithelial Ovarian Cancers: An Institutional Experience.
abstract: The advent of effective chemotherapeutic agents for ovarian carcinoma has made radical abdomino-pelvic radiation redundant. Nevertheless, palliative pelvic radiotherapy still has a role in palliating local symptoms. However, its effect on progression-free survival (PFS) may be debated.
  
  
  
  To study the outcome of fractionated palliative pelvic radiotherapy in relapsed ovarian cancers in terms of symptom control and PFS.
  
  
  
  Twenty-three patients of ovarian cancers, heavily pretreated with chemotherapy and with recurrent or residual pelvic masses, were planned for palliative pelvic radiotherapy to the dose of 46-50 Gy in 23-25 fractions in 4.5-5 weeks. Symptom control and outcomes have been analyzed.
  
  
  
  Post-radiotherapy, abdominal pain was controlled in 15 out of 17 patients (88.2 %), bleeding per vaginum in all 5 patients and vaginal discharge stopped in 4 out of 5 patients (80 %). On follow-up, of 23 patients, 17 (74 %) had progressive disease post-radiation, and median time to disease progression was 10 months (range 1-49). On univariate analysis, increased PFS was observed in patients who received radiation late in their course of disease, those with serous histology, and with lesser disease bulk in pelvis (≤2 cm) prior to radiation initiation.
  
  
  
  Fractionated palliative pelvic radiotherapy is an efficient method for symptom palliation in relapsed ovarian cancers. Patients who are heavily pretreated with chemotherapy and have a small-volume pelvic disease may show a prolonged PFS with addition of pelvic radiotherapy. Indications of radiotherapy, however, need to be defined.
authors.affiliation: Department of Radiotherapy, Nehru Hospital, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India.
authors.forename: Anshuma
authors.initials: A
authors.lastname: Bansal
authors.affiliation: Department of Radiotherapy, Nehru Hospital, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India.
authors.forename: Bhavana
authors.initials: B
authors.lastname: Rai
authors.affiliation: Department of Radiotherapy, Nehru Hospital, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India.
authors.forename: Shikhar
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Radiotherapy, Nehru Hospital, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India.|Department of Gynecology and Obstetrics, Nehru Hospital, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India.
authors.forename: Vanita
authors.initials: V
authors.lastname: Suri
authors.affiliation: Department of Radiotherapy, Nehru Hospital, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India.
authors.forename: Sushmita
authors.initials: S
authors.lastname: Ghoshal
keywords: Ovarian cancer; Palliation; Progression-free survival; Radiotherapy; Recurrent