Gynecological Cancer

PV QA 4 - Poster Viewing Q&A 4

TU_22_3533 - To irradiate or not to irradiate in ovarian cancer?

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

To irradiate or not to irradiate in ovarian cancer?
R. Anghel1,2, X. Bacinschi1,2, L. Gales1,2, M. Mirea1, P. Draghia1, N. Alexandru1, G. Trofin1, and O. G. Trifanescu1,2; 1"Al. Trestioreanu" Institute of Oncology Bucharest, Bucharest, Romania, 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

Purpose/Objective(s): Ovarian cancer is the commonest cause of gynaecological cancer associated death because most of the patients presented in advanced stage. The aim of the study was to evaluate the benefit in terms of disease free survival (DFS) and overall survival (OS) and safety of whole abdominal radiotherapy after surgery and chemotherapy in patients with advanced ovarian cancer.

Materials/Methods: Patients with stage III epithelial ovarian cancer treated in our institution between 2007 and 2016 were included. Twenty-eight patients received whole abdominal radiotherapy (in a 3D conformational manner or as IMRT or VMAT). External beam radiotherapy was administered in a dose of 25 Gy (in 1.5 fractions) to the peritoneal cavity and a supplementation to the pelvis to a total dose of 42.5 Gy after surgery with curative intent and chemotherapy (6 cycles of paclitaxel and carboplatin). Long term oncologic outcome and toxicity was compare to a control group that included 53 stage III ovarian cancer treated with surgery and chemotherapy without radiotherapy.

Results: Median age at diagnosis was 50 years (range 31-74). All patients were diagnosed with stage III epithelial ovarian cancer, with large tumours (mean diameter 85mm), and ascites was presented at diagnosis in 36.3% cases. The big majority of patients (91.7%) underwent primary cytoreduction surgery followed by adjuvant chemotherapy and 8.3% received neoadjuvant chemotherapy followed by surgery. Pathologic report showed that serous papillary histology was documented in 76% and endometrioid in 20% and 4% of the tumours were mucinous adenocarcinoma; more than 52% of the tumours were poorly differentiated G3. After a median follow up of 61 months median estimated DFS and median OS in the radiotherapy group was 24 and 84 months respectively. There was no difference in disease free survival between the two groups (24 vs. 20 months in favour of radiotherapy) but there was a statically significant better OS in the radiotherapy group (84 vs 40 months). The most important independent prognostic factors in both groups was residual disease after surgery: patients with residual disease after surgery had a significant statistically difference in DFS (12 vs. 60 months), OS (48 month vs. not reached) and the benefit of radiotherapy was independent of the amount of residual disease. Radiotherapy was most effective in mucinous subtype. The rate of adverse events grade 3 or 4 after whole abdominal radiotherapy was 16% (one neutropenia and 3 anaemias) and 1 case of bowel obstruction.

Conclusion: Whole abdominal radiotherapy after surgery and chemotherapy in patients with advanced ovarian cancer is feasible, and prolongs overall survival and may be o solution, especially in patients with residual disease.

Author Disclosure: R. Anghel: None. X. Bacinschi: None. L. Gales: None. P. Draghia: None. O.G. Trifanescu: None.

Rodica Anghel, MD, PhD

Presentation(s):

Send Email for Rodica Anghel


Assets

TU_22_3533 - To irradiate or not to irradiate in ovarian cancer?



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for To irradiate or not to irradiate in ovarian cancer?