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Involved-field radiation therapy for selected cases of recurrent ovarian cancer

Other Titles
 . 
Authors
 Nalee Kim  ;  Jee Suk Chang  ;  Sang Wun Kim  ;  Gun Min Kim  ;  Jung-Yun Lee  ;  Yong Bae Kim 
Citation
 JOURNAL OF GYNECOLOGIC ONCOLOGY, Vol.30(5) : e67, 2019 
Journal Title
 JOURNAL OF GYNECOLOGIC ONCOLOGY 
ISSN
 2005-0380 
Issue Date
2019
Keywords
CA-125 Antigen ; Ovarian Cancer ; Platinum Sensitivity ; Radiation Therapy ; Recurrent
Abstract
OBJECTIVES: In our institutional experience, involved-field radiation therapy (IFRT) yields favorable outcomes in patients with recurrent epithelial ovarian cancer (EOC). This retrospective study aimed to investigate the clinical benefits of IFRT in this patient population. METHODS: Among patients treated with IFRT for recurrent EOC between 2010 and 2017, 61 patients with 90 treatments were included. IFRT encompassed all treatable lesions identified via imaging studies with 10-15-mm margins. Prescribed doses were ≥45 Gy (equivalent dose in 2 Gy/fraction). RESULTS: Patients were followed up for a median of 19.0 (Interquartile range, 8.6-34.9) months after IFRT. The 2-year in-field control, progression-free survival, and overall survival (OS) rates were 42.7%, 24.2%, and 78.9%, respectively. Fifty-three IFRT sessions (58.9%) were followed by systemic chemotherapy, and the median chemotherapy-free interval (CFI) was 10.5 (95% confidence interval=7.3-13.7) months. A higher carbohydrate antigen-125 (CA-125) level correlated with a worse 2-year OS (69.2% vs. 91.0%; p=0.001) and shorter median CFI (4.7 vs. 11.9 months; p<0.001). Twenty-eight (31.1%) of 90 treatments yielded a long-term CFI >12 months. For patients with a normal CA-125 level and/or platinum-sensitive tumor, IFRT prolonged CFI regardless of pre-existing carcinomatosis, gross tumor volume, and number of treatment sites. CONCLUSION: Our early experience demonstrates the safety and feasibility of IFRT as an effective salvage therapy and enables a "chemotherapy holiday" in selected recurrent EOC settings. The CA-125 value before IFRT (within normal range) and/or platinum sensitivity could be used as selection criteria for IFRT.
Files in This Item:
T201904546.pdf Download
DOI
10.3802/jgo.2019.30.e67
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gun Min(김건민) ORCID logo https://orcid.org/0000-0001-9167-8682
Kim, Nalee(김나리) ORCID logo https://orcid.org/0000-0003-4742-2772
Kim, Sang Wun(김상운) ORCID logo https://orcid.org/0000-0002-8342-8701
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Lee, Jung Eun(이정은) ORCID logo https://orcid.org/0000-0003-0917-2872
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173369
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