Goldberg H, Stein M E, Steiner M, Sprecher E, Beck D, Kuten A
Department of Oncology, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.
Tumori. 2001 Jul-Aug;87(4):248-51. doi: 10.1177/030089160108700407.
From 1979-1987, 139 stage IC-IV ovarian cancer patients who had undergone cytoreductive surgery received 6-11 cycles of cisplatin and adriamycin.
Eighty-four clinically complete responders underwent second-look laparotomy, and 60 of them received consolidation abdominal irradiation. The patients were then followed for a median follow-up of 39 months.
Five- and 10-year actuarial survival for all patients was 43% and 24%, for no residuum at primary surgery, 80% and 35%, for residual tumor <2 cm, 45% and 35%, and for residual tumor >2 cm, 20% and 4%. Median survival for stage III-IV patients negative at second-look laparotomy was 72 months in irradiated compared to 25 months in non-irradiated patients (P = 0.14) and 77 months in irradiated patients with microscopic disease at second-look laparotomy. Median survival in patients with macroscopic disease at second-look laparotomy was 23.5 months if irradiated compared to 18 months if not (P = 0.05).
Consolidation whole abdominal irradiation in advanced stages of ovarian cancer may be of value in patients with negative or microscopic disease at second-look laparotomy. Unfortunately, despite the initial survival advantage observed in irradiated patients, owing to late recurrences there was no significant difference in their long-term survival probability.
1979年至1987年期间，139例接受了肿瘤细胞减灭术的IC-IV期卵巢癌患者接受了6至11个周期的顺铂和阿霉素治疗。
84例临床完全缓解者接受了二次剖腹探查术，其中60例接受了巩固性腹部放疗。随后对患者进行了中位39个月的随访。
所有患者的5年和10年精算生存率分别为43%和24%；初次手术无残留者为80%和35%；残留肿瘤<2 cm者为45%和35%；残留肿瘤>2 cm者为20%和4%。二次剖腹探查术结果为阴性的III-IV期患者，接受放疗者的中位生存期为72个月，未接受放疗者为25个月（P = 0.14），二次剖腹探查术有微小病灶的放疗患者中位生存期为77个月。二次剖腹探查术有肉眼可见病灶的患者，接受放疗者的中位生存期为23.5个月，未接受放疗者为18个月（P = 0.05）。
对于二次剖腹探查术结果为阴性或有微小病灶的晚期卵巢癌患者，巩固性全腹放疗可能有价值。遗憾的是，尽管放疗患者最初观察到生存优势，但由于晚期复发，其长期生存概率并无显著差异。
