Whole-abdomen radiation therapy as salvage treatment for epithelial ovarian carcinoma

This study aimed to evaluate the efficacy and safety of whole-abdomen radiation therapy as salvage treatment in patients with ovarian cancer.

Twenty-seven patients who failed aggressive cytoreductive surgery followed by multiple-drug platinum-based chemotherapy were found to have recurrent epithelial carcinoma of the ovary and were treated with whole-abdomen radiation as salvage therapy. Dosage fractions were planned at 100 to 150 cGy daily to 3000 to 3500 cGy, followed by a pelvic boost at 150 to 180 cGy daily. All patients completed the planned treatment. The average treatment program required 53.5 days (range, 42-71 days).

Survival rates at years 1 through 5 were 66%, 48%, 26%, 15%, and 15%, respectively. Residual disease at initiation of radiation correlated strongly with length of survival. The patients with microscopic disease survived an average of 63 months (range, 30-111 months). Patients with disease larger than 2 cm survived an average of 9 months (range, 5-17 months). Toxicity was seen in all patients. Eight patients experienced grade 3 or 4 toxicity, primarily white blood cell count and gastrointestinal toxicity. There were no deaths related to toxicity.

This experience strongly suggests that whole-abdomen radiation is a viable salvage option, especially for patients with microscopic retroperitoneal disease or small-volume macroscopic disease.