Radiotherapy for isolated recurrent epithelial ovarian cancer: A single institutional experience

Komura, Naoko; Mabuchi, Seiji; Isohashi, Fumiaki; Yokoi, Eriko; Shimura, Kentaro; Matsumoto, Yoshihisa; Kodama, Michiko; Tomimatsu, Takuji; Ogawa, Kazuhiko; Kimura, Tadashi

doi:10.1111/jog.13947

Cited by 9 publications

(6 citation statements)

References 18 publications

(31 reference statements)

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“…(7). Regarding numbers of prior CT regimens, our nding is contrary to previous study which suggested that patients exposed to one prior CT regimens showed longer duration of survival than those administered with more prior CT regimens (15). The reason why numbers of CT cycles before RT was identi ed as a prognostic factor remains uncovered, and further mechanistic research should be undertaken to explore the underlying mechanism.…”

Section: Discussioncontrasting

confidence: 90%

“…The 3-year LC rate was 75.5%, supporting recent studies documenting that RT yielded satisfying local control outcome in OC patients (10,12,13). Besides, in agreement with other researches (14,15), survival after RT had no correlation with platinum sensitivity at the onset of RT, indicating that RT could serve as an effective modality in the treatment of OC patients irrespective of platinum status. (7).…”

Section: Discussionsupporting

confidence: 88%

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Adjuvant Pelvic Radiotherapy in Ovarian Cancer: Outcomes By Risk Factors

Chen

Mei

Liang

et al. 2021

Preprint

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Background: Radiotherapy (RT) is not the current standard treatment option for ovarian cancer (OC) patients. The present study aims to explore the risk factors of adjuvant pelvic RT for patients with OC and to investigate prognostic factors associated with longer progression free survival (PFS) and overall survival (OS) period.Methods: From April 2004 to September 2020, OC patients administered with RT were collected retrospectively at our institution and those who received pelvic RT were selected for further analysis. Kaplan-Meier method was employed to estimate the PFS, OS and local control (LC) rate. Univariate and multivariate cox regression model were established to identify potential beneficiaries of pelvic RT.Results: Overall, a total of 89 OC patients underwent RT were identified, 70 of whom were treated with adjuvant pelvic RT and were eligible for final analysis. Median follow-up was 51.0 months. The estimated 3-year OS rate was 48.1% and 3-year PFS rate was 26.8%, respectively. CACTE grade 4 to 5 toxicities were observed in 2 patients. Multivariate cox model illustrated that high-grade serous carcinoma (HGSC), advanced stage disease (FIGO stage III & IV), receiving pelvic RT during multiple relapses as well as no previous chemotherapy (CT) were independent risk factors for PFS. Additionally, patients with 0-1 risk factor had a longer PFS time than those with 2-4 risk factors.Conclusions: Pelvic RT was well tolerated and had favorable efficacy in OC patients with low risk factor (0-1), which might confer prolonged survival. However, further investigations are needed.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Adjuvant Pelvic Radiotherapy in Ovarian Cancer: Outcomes By Risk Factors

Chen

Mei

Liang

et al. 2021

Preprint

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“…In this real-world research that included 20031 OC patients, we found that the median OS of the RT group was 23 months, and 1-year, 2-year, and 3-year OS rates were 66.3%, 49.4%, and 40.7%, respectively, which were slightly worse than reported previously [ 14 , 19 ]. The difference could be explained by different sample sizes, radiation fields, dose and modality, and so on.…”

Section: Discussioncontrasting

confidence: 52%

“…Thus the position of RT in OC may be reconsidered [ 11 ]. However, current studies for RT on OC were limited, and the sample sizes were small [ 12 – 14 ]. Aimed to explore the survival impact of radiotherapy in OC, we analyzed the real-world data from the Surveillance, Epidemiology, and End Results (SEER) Database.…”

Section: Introductionmentioning

confidence: 99%

Survival Analysis of Radiation Therapy in Ovarian Cancer: A SEER Database Analysis

Gong

et al. 2021

Journal of Oncology

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Background and purpose. A large sample size study on survival analysis of radiotherapy in ovarian cancer is deficient. This study aimed to explore the survival impact of radiotherapy in ovarian cancer. Materials and methods. Data of patients diagnosed with ovarian cancer between 2010 and 2015 were collected from Surveillance, Epidemiology, and End Results (SEER) Database. Survival comparisons were analyzed using Kaplan–Meier analysis and log-rank tests. Univariate and multivariate Cox regression analyses were used to select predictors associated with survival. Propensity score matching (PSM) analysis was employed to balance baseline variables. Results. A total of 20031 ovarian cancer patients were included, with 291 (1.45%) patients who received radiotherapy. The median overall survival (OS) in patients who received radiotherapy was shorter than which in patients without radiotherapy (23 vs. 75 months, P < 0.001 ). The Elderly, nonepithelial pathology, advanced American Joint Committee on Cancer (AJCC) stage, elevated level of CA125, and receiving radiotherapy were risk predictors to survival in both multivariable analyses before and after PSM. Among 11872 patients with III/IV stage, the radiotherapy group also showed a significantly worse prognosis (median OS: 19 vs. 44 months in patients without radiotherapy, P < 0.001 ). Consistent results were observed in stratification analyses on pathology and stage among patients with III/IV stage. Conclusions. For patients with ovarian cancer, radiotherapy was associated with a poor prognosis regardless of pathology or stage. Considering this is a retrospective study, future studies concerning radiotherapy combination with other new agents in ovarian cancer are needed.

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“…Salvage WAI (30-35 Gy, followed by a pelvic boost), has been employed in an effort to improve outcomes (53). Selective approaches with highly conformal radiotherapy (CRT) have been used in case of limited recurrent disease (nodal or extranodal non-debulkable disease) with no disease dissemination, a subset of these patients may have oligometastatic or oligoprogressive disease that may beneficiate from RT instead of surgery with the potential for long-term disease control (Table 4) (54)(55)(56)(57)(58).…”

Section: Salvage Rt For Recurrent Diseasementioning

confidence: 99%

Radiotherapy in women with epithelial ovarian cancer: historical role, current advances, and indications

Flores-Balcázar¹,

Urías-Arce²

2020

Chin Clin Oncol

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Epithelial ovarian cancer (OC) is known to be a neoplasm responsive to radiotherapy (RT).Nevertheless, the role of RT in the management of this disease represent a topic of controversy, and the indications for its use are not fully established. Initial studies suggested that the addition of RT in the form of intraperitoneal (IP) radioisotopes was useful. Indications for this treatment were peritoneal cytology with tumor cells, peritoneal implants, and capsule rupture. The instillation of radioisotopes was contraindicated when macroscopic residual disease was present. Pelvic RT was used after surgery in patients with an absence of gross residual disease. Early studies established the inadequacy of this technique and the need for treating the whole abdomen. Whole abdominal irradiation (WAI) was a therapeutic tool used in the prechemotherapy era to eradicate large amounts of microscopic peritoneal disease. Ideal candidates for WAI were stage I patients with grade 2 or 3 tumors; stage II patients with grade 1 or 2 tumors and residual disease, and stage III, grade 1 patients with <2 cm residual disease. The disadvantages of WAI were the dose-limiting toxicities, which were predominantly acute hematologic and late gastrointestinal. The era of aggressive debulking and platinum agents made WAI fall out of favor as a treatment of OC. Selective approaches with highly conformal radiotherapy (CRT) have been used in case of limited recurrent or unresectable disease with the potential for long-term disease control. Currently, the role of RT in OC applies for patients with recurrent oligometastatic or oligoprogressive disease and in the palliative setting for symptom control. We performed a nonsystematic review and included data from both retrospective and prospective studies focusing on the use of RT for OC and its biological rationale. Furthermore, ongoing trials on this issue are reported.

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Radiotherapy for isolated recurrent epithelial ovarian cancer: A single institutional experience

Cited by 9 publications

References 18 publications

Adjuvant Pelvic Radiotherapy in Ovarian Cancer: Outcomes By Risk Factors

Adjuvant Pelvic Radiotherapy in Ovarian Cancer: Outcomes By Risk Factors

Survival Analysis of Radiation Therapy in Ovarian Cancer: A SEER Database Analysis

Radiotherapy in women with epithelial ovarian cancer: historical role, current advances, and indications

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