Involved-field radiation therapy for locoregionally recurrent ovarian cancer
Involved-field radiation therapy for locoregionally recurrent ovarian cancer
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DOI：
10.1016/j.ygyno.2013.04.469
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发表时间：
2013-08-01
影响因子：
4.7
通讯作者：
Eifel, Patricia J.
中科院分区：
文献类型：
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作者：
Brown, Aaron P.;Jhingran, Anuja;Eifel, Patricia J.
客观的。评估确定性受累野放射治疗 (IFRT) 对选定的局部复发性卵巢癌患者的有效性。方法。我们回顾性审查了 102 名接受明确 IFRT (>= 45 Gy) 治疗的上皮性卵巢癌患者的记录。 IFRT 针对局部淋巴结（49%）和结外（51%）复发。结果。从诊断到 IFRT 的中位时间为 36 个月（范围，1-311），IFRT 后的中位随访时间为 37 个月（范围，1-123）。患者在 IFRT 之前平均接受了三个化疗疗程（范围，0-9）。 IFRT 后五年总生存率 (OS) 和无进展生存率 (PFS) 分别为 40% 和 24%； 5年田间病害控制率为71%。 35 名患者 (35%) 在 IFRT 后中位 38 个月（范围为 7-122）时没有疾病证据，其中 25 名患者中位无病持续时间为 61 个月（范围为 17-122），10 名患者在疾病复发后接受抢救治疗，抢救治疗后中位无病时间为 39 个月（范围为 7-92）。 8 名透明细胞癌患者的 5 年 OS（88% 对比 37%；p = 0.05）和 PFS（75% 对比 20%；p = 0.01）率高于其他患者。对初始铂类化疗敏感的患者比铂类耐药患者的 5 年 OS 率更高（43% vs 27%，p = 0.03）。 IFRT 后因复发而需要化疗的患者通常受益于 IFRT 后比 IFRT 前更长的无化疗间隔。结论。明确的 IFRT 可以实现良好的局部控制、延长无病间隔，甚至可以治愈精心挑选的患者。放疗应被视为治疗局部复发性卵巢癌的一种工具。 (c) 2013 Elsevier Inc. 保留所有权利。
Objective. To evaluate the effectiveness of definitive involved-field radiation therapy (IFRT) for selected patients with locoregionally-recurrent ovarian cancer.Methods. We retrospectively reviewed records of 102 epithelial ovarian cancer patients treated with definitive IFRT (>= 45 Gy). IFRT was directed to localized nodal (49%) and extranodal (51%) recurrences.Results. The median time from diagnosis to IFRT was 36 months (range, 1-311), and the median follow-up after IFRT was 37 months (range, 1-123). Patients received a median of three chemotherapy courses before IFRT (range, 0-9). Five-year overall (OS) and progression-free survival (PFS) rates after IFRT were 40% and 24% respectively; the 5-year in-field disease control rate was 71%. Thirty-five patients (35%) had no evidence of disease at a median of 38 months after IFRT (range, 7-122), including 25,continuously without disease for a median of 61 months (range, 17-122) and 10 with salvage treatment following disease recurrence, disease-free for a median of 39 months after salvage treatment (range, 7-92). Eight clear cell carcinoma patients had higher 5-year OS (88% versus 37%; p = 0.05) and PFS (75% versus 20%; p = 0.01) rates than other patients. Patients sensitive to initial platinum chemotherapy had a higher 5-year OS rate than platinum-resistant patients (43% versus 27%, p = 0.03). Patients who required chemotherapy for recurrence after IFRT often benefitted from longer chemotherapy-free intervals after than before IFRT.Conclusions. Definitive IFRT can yield excellent local control, protracted disease-free intervals, and even cures in carefully selected patients. RT should be considered a tool in the curative management of locoregionally-recurrent ovarian cancer. (c) 2013 Elsevier Inc. All rights reserved.