Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents

Butala, Anish A.; Patel, Roshal R.; Manjunath, Shwetha; Latif, Nawar; Haggerty, Ashley; Jones, Joshua; Taunk, Neil K.

doi:10.1016/j.adro.2020.11.009

Cited by 8 publications

(8 citation statements)

References 32 publications

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“…Even without serious CNS toxicity in acute or early-delayed phase, delayed significant CNS toxicity of this fractionated radiotherapy still could be a concern (30). Recently, Butala et al reported that cumulative biologically effective doses >39 Gy were associated with improved clinical response in CNS lesions without obvious toxicities, but there was a lack of information on tumor sizes in this study (31). GKS has overcome several of these limitations in a fundamental way.…”

Section: Discussionmentioning

confidence: 71%

Gamma Knife Radiosurgery-Based Combination Treatment Strategies Improve Survival in Patients With Central Nervous System Metastases From Epithelial Ovarian Cancer: A Retrospective Analysis of Two Academic Institutions in Korea and Taiwan

et al. 2021

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Central nervous system (CNS) metastases from epithelial ovarian cancer (EOC) are rare. We investigated the clinico-pathological prognostic factors of patients with CNS metastases from EOC and compared the outcomes of various treatment modalities. We retrospectively reviewed the records of patients with CNS metastases from EOC between 2000 and 2020. Information on the clinical and pathological characteristics, treatment, and outcomes of these patients was retrieved from Samsung Medical Center and National Taiwan University Hospital. A total of 94 patients with CNS metastases were identified among 6,300 cases of EOC, resulting in an incidence of 1.49%. Serous histological type [hazard ratio (HR): 0.49 (95% confidence interval [CI] 0.25-0.95), p=0.03], progressive disease [HR: 2.29 (95% CI 1.16-4.54), p=0.01], CNS involvement in first disease relapse [HR: 0.36 (95% CI 0.18-0.70), p=0.002], and gamma knife radiosurgery (GKS)-based combination treatment for EOC patients with CNS lesions [HR: 0.59 (95% CI 0.44-0.79), p<0.001] significantly impacted survival after diagnosis of CNS metastases. In a subgroup analysis, superior survival was observed in patients with CNS involvement not in first tumor recurrence who underwent GKS-based combination therapeutic regimens. The survival benefit of GKS-based treatment was not significant in patients with CNS involvement in first disease relapse, but a trend for longer survival was still observed. In conclusion, GKS-based combination treatment can be considered for the treatment of EOC patients with CNS metastases. The patients with CNS involvement not in first disease relapse could significantly benefit from GKS-based combination strategies.

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Section: Discussionmentioning

confidence: 71%

Gamma Knife Radiosurgery-Based Combination Treatment Strategies Improve Survival in Patients With Central Nervous System Metastases From Epithelial Ovarian Cancer: A Retrospective Analysis of Two Academic Institutions in Korea and Taiwan

et al. 2021

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“…Generally ovarian cancer carries a high risk of late presentation and poor outcomes, but this risk is worse in Africa where diagnostic and treatment capacity is limited 9 10. In modern practice, radiotherapy is typically not employed in the management of ovarian cancer, except for localized palliative treatment 11…”

Section: Role and Place Of Radiotherapy For Gynecological Malignancie...mentioning

confidence: 99%

“…9 10 In modern practice, radiotherapy is typically not employed in the management of ovarian cancer, except for localized palliative treatment. 11…”

Section: Role and Place Of Radiotherapy For Gynecological Malignancie...mentioning

confidence: 99%

Gynecological radiation oncology in sub-Saharan Africa: status, problems and considerations for the future

Lombe

M'ule

Msadabwe³

et al. 2022

Int J Gynecol Cancer

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Gynecological malignancies in Africa form a significant part of the burden of disease. The high prevalence of HIV in some countries creates a heightened risk for development of human papilloma virus related cancers such as cervical, vulval and vaginal cancers. Radiotherapy is an important modality of treatment for cancer and in Africa compensates for the lack of adequate surgical services for a large proportion of cancers as well as being a cornerstone of treatment for locally advanced cancers and palliation. In this review we look at the status of radiotherapy services in sub-Saharan Africa and critical factors that influence its delivery with a focus on gynecological malignancies. This unveils that radiotherapy for gynecological cancers in sub-Saharan Africa is a significant example of the need for a holistic development approach across different sectors of the economy and different disciplines of medicine. The complexity of its management continues to expose the underdevelopment of health and financial systems and the lack of universal health coverage and social systems as we continue to see unnecessary morbidity and mortality due to the lack of organization. More systematic and scientifically robust investigations tailored to the various sub-Saharan Africa countries need to be conducted to elicit disruptive local solutions to the status quo.

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“…In vulvar cancer, the target includes the intact primary disease or the post-surgical bed with or without treatment to the pelvis or inguinal lymph nodes. Radiotherapy for ovarian cancer is limited in routine use, but can be used effectively in palliation 5. Treatment at these regions may expose significant volumes of normal tissues to radiation-related toxicity.…”

Section: Introductionmentioning

confidence: 99%

“…Radiotherapy for ovarian cancer is limited in routine use, but can be used effectively in palliation. 5 Treatment at these regions may expose significant volumes of normal tissues to radiation-related toxicity. Toxicities include acute and late damage to the bowel, rectum, bladder, bone, and bone marrow.…”

Section: Introductionmentioning

confidence: 99%

The role of proton therapy in gynecological radiation oncology

Taunk

2022

Int J Gynecol Cancer

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Proton beam therapy is an external beam radiotherapy modality that offers potentially similar efficacy and reduced toxicity compared with photon radiotherapy due to little to no exit dose of radiation beyond the intended target. Improvements in radiotherapy from two-dimensional, to three-dimensional, to intensity-modulated radiation therapy have offered comparable to improved efficacy of radiation therapy with progressive reductions in toxicity. Proton beam therapy may offer further improvements, with multiple dosimetric studies demonstrating potential reductions in exposure of normal tissue to radiation, particularly bowel and bone marrow. Proton beam therapy offers avenues for dose escalation or re-irradiation, which were previously not feasible with photon radiotherapy. Although early clinical data generally demonstrate safety, feasibility, and efficacy in a few series, prospective clinical trials are limited and needed to better define who might benefit from proton therapy. In this review, we discuss the history, dosimetry, available clinical data, and technical needs to deliver high-quality proton therapy.

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Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents

Cited by 8 publications

References 32 publications

Gamma Knife Radiosurgery-Based Combination Treatment Strategies Improve Survival in Patients With Central Nervous System Metastases From Epithelial Ovarian Cancer: A Retrospective Analysis of Two Academic Institutions in Korea and Taiwan

Gamma Knife Radiosurgery-Based Combination Treatment Strategies Improve Survival in Patients With Central Nervous System Metastases From Epithelial Ovarian Cancer: A Retrospective Analysis of Two Academic Institutions in Korea and Taiwan

Gynecological radiation oncology in sub-Saharan Africa: status, problems and considerations for the future

The role of proton therapy in gynecological radiation oncology

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