Whole abdomen radiation therapy after a short chemotherapy course and second-look laparotomy in advanced ovarian cancer

Journal Article · Sat Jun 01 00:00:00 EDT 1991 · Gynecologic Oncology; (United States)

DOI:https://doi.org/10.1016/0090-8258(91)90309-S· OSTI ID:6394216

Franchin, G; Tumolo, S; Scarabelli, C; De Paoli, A; Boz, G; Crivellari, D; Arcicasa, M; Bortolus, R; Gobitti, C; Minatel, E ^[1]

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1. Radiotherapy Department, Centro di Riferimento Oncologico, Aviano, Pordenone (Italy)

From April 1983 through December 1989, 42 consecutive patients with diagnosis of epithelial ovarian carcinoma were initially managed by aggressive surgery and three courses of endoperitoneal cis-platinum-based chemotherapy followed by an alternating combination chemotherapy and second-look laparotomy. Patients with residual tumor less than or equal to 2 cm subsequently received whole abdominal radiation therapy (WAR). Twenty-eight patients (42% with no residual disease, 21% with microscopic disease, and 36% with residual disease less than 2 cm) were eligible for WAR. WAR was delivered using an open-field technique up to 22 Gy in 20 fractions followed by a pelvic boost of 18 Gy in 10 fractions. The kidneys were shielded posteriorly at 1100 cGy; hepatic shields were not added. One patient did not complete WAR for lung metastases after 5 radiotherapy fractions. The complete treatment program lasted 8 months (range, 6.8-11). The median follow-up of the 28 patients entered into the study was 50 months. Eight patients are alive and disease-free at 5 years. The overall and disease-free survival rates at 5 years are 45 and 30%, respectively. All but 2 patients relapsed within the abdominopelvic cavity and 3 developed brain metastases. Toxic effects, during WAR, required treatment interruption in all but 4 patients: 3 developed a small bowel obstruction requiring surgery and 1 died of surgical complications in complete remission. The poor disease-free survival and the severe toxicity encountered have been valid indications that WAR should be discontinued as a treatment modality in advanced ovarian cancer at the authors department.

• OSTI ID: 6394216
• Journal Information: Gynecologic Oncology; (United States), Vol. 41:3; ISSN 0090-8258
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ABDOMEN
IRRADIATION
CARCINOMAS
COMBINED THERAPY
OVARIES
DOSE-RESPONSE RELATIONSHIPS
METASTASES
PATIENTS
SURVIVAL CURVES
BODY
BODY AREAS
DISEASES
FEMALE GENITALS
GONADS
NEOPLASMS
ORGANS
THERAPY
550603* - Medicine- External Radiation in Therapy- (1980-)
550600 - Medicine