Involved-Field Radiation Therapy for Locoregionally Recurrent Ovarian Cancer (IFRT/note: clear cell)

Blogger's Note: there are no adverse events/effects listed in this abstract; 'definitive' needs to be clarified; requires further information via full research paper to be informative

Involved-Field Radiation Therapy for Locoregionally Recurrent Ovarian Cancer

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Highlights

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Selected ovarian cancer patients with locoregionally-confined recurrences were treated with definitive involved-field radiation therapy (IFRT).

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IFRT produced high rates of in-field disease control and prolonged disease-free intervals of up to 10 years in some patients.

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Some patients with disease progression following IFRT may benefit from RT through longer breaks from chemotherapy.

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Objective

To evaluate the effectiveness of definitive involved-field radiation therapy (IFRT) for selected patients with locoregionally-recurrent ovarian cancer.

Methods

We retrospectively reviewed records of 102 epithelial ovarian cancer patients treated with definitive IFRT (≥ 45 Gy). IFRT was directed to localized nodal (49%) and extranodal (51%) recurrences.

Results

The median time from diagnosis to IFRT was 36 months (range, 1-311), and the median follow-up after IFRT was 37 months (range, 1-123). Patients received a median of three chemotherapy courses before IFRT (range, 0-9). Five-year overall (OS) and progression-free survival (PFS) rates after IFRT were 40% and 24% respectively; the 5-year in-field disease control rate was 71%.

Thirty-five patients (35%) (??) had no evidence of disease at a median of 38 months after IFRT (range, 7-122), including 25 continuously without disease for a median of 61 months (range, 17-122) and 10 with salvage treatment following disease recurrence, disease-free for a median of 39 months after salvage treatment (range, 7-92).

Eight clear cell carcinoma patients had higher 5-year OS (88% versus 37%; p = 0.05) and PFS (75% versus 20%; p = 0.01) rates than other patients. Patients sensitive to initial platinum chemotherapy had a higher 5-year OS rate than platinum-resistant patients (43% versus 27%, p = 0.03). Patients who required chemotherapy for recurrence after IFRT often benefitted from longer chemotherapy-free intervals after than before IFRT.

Conclusions

Definitive IFRT can yield excellent local control, protracted disease-free intervals, and even cures in carefully selected patients. RT should be considered a tool in the curative management of locoregionally-recurrent ovarian cancer.