Postoperative whole abdominal radiotherapy in clear cell adenocarcinoma of the ovary.

Abstract

OBJECTIVES:

The aim of this study was to clarify the efficacy of postoperative whole abdominal radiotherapy (WAR) for ovarian clear cell adenocarcinoma (OCCA).

METHODS:

Between 1996 and 2004, 16 patients with OCCA underwent initial debulking surgery and received postoperative WAR. Indications for WAR were as follows: OCCA, International Federation of Gynaecology and Obstetrics (FIGO) stage Ic-III, no macroscopic residual disease in the upper abdomen and residual disease in the pelvic cavity < or = 2 cm. The planned WAR comprised external beam radiotherapy (EBRT) to the entire abdominal cavity with 22.0-24.0 Gy/22-24 fractions followed by EBRT to the pelvis with 23.4-21.6 Gy/12-13 fractions. Overall survival (OS) and disease-free survival (DFS) were compared with 12 historical control (HC) patients treated with initial debulking surgery followed by platinum-based chemotherapy.

RESULTS:

The FIGO stage in the WAR group was stage Ic in 11 patients, stage II in 3, and stage III in 2. Fifteen of the 16 patients (94%) completed the planned WAR. Two patients developed radiation enterocolitis and required bowel surgery. Five-year OS and DFS in the WAR/HC group were 81.8%/33.3% and 81.2%/25.0% (p=0.031 and p=0.006), respectively.

CONCLUSIONS:

This study suggests that postoperative WAR may be effective in selected patients with OCCA. Prospective randomized trials should be considered to assess postoperative WAR for OCCA.

• Authors: Yutaka Nagai, Morihiko Inamine, Makoto Hirakawa, Kazuya Kamiyama, Kazuhiko Ogawa, Takafumi Toita, Sadayuki Murayama, Yoichi Aoki
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 107 Issue 3 Pg. 469-73 (Dec 2007) ISSN: 1095-6859 [Electronic] United States
• PMID: 17765295 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Doxorubicin
• Cyclophosphamide
• Cisplatin

Topics

• Adenocarcinoma, Clear Cell (drug therapy, pathology, radiotherapy, surgery)
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Cisplatin (administration & dosage)
• Combined Modality Therapy
• Cyclophosphamide (administration & dosage)
• Doxorubicin (administration & dosage)
• Female
• Humans
• Middle Aged
• Neoplasm Recurrence, Local (pathology)
• Neoplasm Staging
• Ovarian Neoplasms (drug therapy, pathology, radiotherapy, surgery)
• Postoperative Care
• Radiotherapy (adverse effects)