Clinical analysis of conformal and intensity-modulated radiotherapy in patients with recurrent ovarian cancer

Abstract

We aimed to provide evidence for radiotherapy treatment regimens in patients with clinically recurrent ovarian cancer. We analyzed the survival and prognostic factors in 43 patients who were treated for recurrent ovarian cancer at 58 tumor sites using three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) during January 2006–December 2017. t years 1, 2, and 3, overall survival (OS) rate was 82.4%, 68.4%, and 57.9%; local control (LC) rate was 100%, 100% and 80%; recurrence free survival (RFS) rate was 86.8%, 66.6%, and 61.1%; and disease-free survival (DFS) rate was 79.7%, 56.7%, and 46.8%, respectively. The radiotherapy technique was determined to be an independent prognostic factor for survival; the survival rate of patients was significantly improved with IMRT compared to 3D-CRT (P = 0.035). Radiotherapy dose was an independent prognostic factor; survival rate improved when patients were treated with a radiation dose ≥ 60 Gy as compared to < 60 Gy (P = 0.046). Elective nodal prophylactic radiation therapy (ENRT) did not lead to a significant improvement in survival when compared to involved-field radiation therapy (IFRT). The toxicities of 3D-CRT and IMRT were tolerable. One patient (2.3%) had grade 3 acute gastrointestinal (GI) toxicity, 2 (4.6%) grade 3 late GI toxicity, 5 (11.6%) grade 3 hematological toxicity, and 2 (4.6%) had grade 4 hematological toxicity. IMRT improved LC and OS in patients with recurrent ovarian cancer after surgery and multiple chemotherapy; toxicities were tolerable. The IMRT technique and radiotherapy dose of ≥ 60 Gy had independent prognostic significance for the survival of such patients.

Long term-control via successful salvage therapy with cytoreductive surgery, chemotherapy, and radiotherapy for recurrence with intraperitoneal carcinomatosis of synchronous advanced ovarian and endometrial cancer: a case report

“…The suspected residual lesions in the right external iliac area received boosts of up to 59.4 Gy based on the surgical findings and CT simulation of salvage radiotherapy (Figure 3). Suspected residual clear cell carcinomas may require boosting with ≥60 Gy, which was independently prognostic of improved survival in one recent retrospective study (14).…”

KLHL14: A Novel Prognostic Biomarker and Therapeutic Target for Ovarian Cancer

“…With advancements in the technology of radiotherapy and a corresponding decrease in the toxicities, radiotherapy has been widely used in the treatment of recurrent OV [ 29 ]. However, to date, the outcome of patients with OV has not improved [ 30 ]. The mechanism underlying the development of resistance to chemotherapeutic agents in ovarian cancer is very complex [ 31 ].…”

Efficacy and Safety of Recombinant Human Adenovirus Type 5 (H101) in Persistent, Recurrent, or Metastatic Gynecologic Malignancies: A Retrospective Study

“…These patients often received multiple chemotherapy or high-dose radiation treatments, which reduced the quality of their health and result in less benefit from systemic therapy. Therefore, local therapy is more likely to be an effective strategy, in which precision radiotherapy is an important option for local therapy ( 15 – 17 ). Unfortunately, for the patients who had received radiotherapy before, it is difficult to achieve satisfactory prescription dose again.…”