Jee Suk Chang1, Sang Wun Kim2, Yeon-Joo Kim3, Joo-Young Kim3, Sang-Yoon Park3, Jin Hee Kim4, Tae-Kyu Jang5, Yong Bae Kim6. 1. Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea. 2. Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea. 3. Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea. 4. Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea. 5. Department of Obstetrics and Gynecology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea. 6. Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: ybkim3@yuhs.ac.
Abstract
OBJECTIVE: To evaluate the efficacy and safety of involved-field radiation therapy (IFRT) in patients with locoregionally confined recurrent or persistent epithelial ovarian cancer. METHODS: This study included patients with recurrent epithelial ovarian cancer eligible for IFRT either during diagnosis of the recurrence or after salvage therapies. IFRT was performed at a dose of ≥45 Gy for all tumors with 10-15-mm margins as seen on standard imaging. The primary endpoint was progression-free survival (PFS); the secondary endpoints were safety, response rate, local control, and overall survival (OS). RESULTS: Thirty patients with a mean number of 5.7 metastatic lesions each were enrolled between 2014 and 2016. Seventeen were treated with 3-D conformal radiation therapy (RT) and 13 with intensity-modulated RT. IFRT was well tolerated in all patients, and acute toxicity ≥ grade 2 was not observed. One case of grade 3 abdominal pain was reported 10 months post-RT. The overall and complete response rates were 85.7% and 50%, respectively. After a median follow-up of 28 (range, 17-42) months, the median PFS was 7 months. The 2-year PFS rate was 39.3%. Six of the 16 patients who developed outfield disease progression after IFRT were successfully treated with repeat IFRT as salvage treatment. The 3-year local control and OS rates were 84.4% and 55.8%, respectively. CONCLUSIONS: Although the primary endpoint was not met, IFRT might be safe and effective for in-field tumor control in patients with persistent epithelial ovarian cancer with a limited number of metastatic foci. We plan to conduct a larger scale multi-center phase II prospective study.
OBJECTIVE: To evaluate the efficacy and safety of involved-field radiation therapy (IFRT) in patients with locoregionally confined recurrent or persistent epithelial ovarian cancer. METHODS: This study included patients with recurrent epithelial ovarian cancer eligible for IFRT either during diagnosis of the recurrence or after salvage therapies. IFRT was performed at a dose of ≥45 Gy for all tumors with 10-15-mm margins as seen on standard imaging. The primary endpoint was progression-free survival (PFS); the secondary endpoints were safety, response rate, local control, and overall survival (OS). RESULTS: Thirty patients with a mean number of 5.7 metastatic lesions each were enrolled between 2014 and 2016. Seventeen were treated with 3-D conformal radiation therapy (RT) and 13 with intensity-modulated RT. IFRT was well tolerated in all patients, and acute toxicity ≥ grade 2 was not observed. One case of grade 3 abdominal pain was reported 10 months post-RT. The overall and complete response rates were 85.7% and 50%, respectively. After a median follow-up of 28 (range, 17-42) months, the median PFS was 7 months. The 2-year PFS rate was 39.3%. Six of the 16 patients who developed outfield disease progression after IFRT were successfully treated with repeat IFRT as salvage treatment. The 3-year local control and OS rates were 84.4% and 55.8%, respectively. CONCLUSIONS: Although the primary endpoint was not met, IFRT might be safe and effective for in-field tumor control in patients with persistent epithelial ovarian cancer with a limited number of metastatic foci. We plan to conduct a larger scale multi-center phase II prospective study.
Authors: Anish A Butala; Roshal R Patel; Shwetha Manjunath; Nawar A Latif; Ashley F Haggerty; Joshua A Jones; Neil K Taunk Journal: Adv Radiat Oncol Date: 2020-11-25
Authors: Maria T Löblein; Isabel Falke; Hans Theodor Eich; Burkhard Greve; Martin Götte; Fabian M Troschel Journal: Int J Mol Sci Date: 2021-10-25 Impact factor: 5.923