Fournier D, Kubli F, Kuttig H, Hinderer H, Drings P
Strahlentherapie. 1975 Sep;150(3):280-7.
From 1960 to 1972, 276 out of 330 cases of ovarian cancer were treated by different techniques of postoperative radiation therapy; 54 advanced cases underwent prospective chemotherapy. Radiogold intraabdominally administered (190 to 300 mCi), telecobalt (5000 rd) or the combination of radiogold and telecobalt was chosen for postoperative radiation therapy. Cyclophosphamide (Endoxan), prednisolone, and gestagenes (Prothil) were given as a long-term chemotherapy. The most successful technique of radiation therapy is confronted with long-term chemotherapy after three years (five years) of survival: Stage I a, b, c: Radiogold = 91.7% (66.7%), chemotherapy (only I c) = 100%. Stage II a, b: Radiogold + telecobalt = 47% (35%), chemotherapy = 85%. Stage III: Radiogold + telecobalt = 25% (0%), chemotherapy = 52%. Stage IV: Radiotherapy = 0%, chemotherapy = 25%. The absolute five-year survival without chemotherapy amounted to 23%. The mortality curve under chemotherapy shows a four-year survival rate of 88%, if tumor cells had been detected microscopically (ascites, omentum), but of only 30% after macroscopical verification of the tumor. Therefore, the maximally possible partial resection of the tumor is recommended in inoperable stages before the beginning of chemotherapy. "Prophylactic" long-term chemotherapy following macroscopically complete surgical treatment is recommended, whenever microscopical spread of tumor cells appears to be possible. In inoperable stages, chemotherapy ought to be applied prior to radiation therapy. In stages I a, b, c, and II a, postoperative irradiation with radiogold (100 mCi) and in stage II b additionally radiation teletherapy of the pelvis (6000 rd) is recommended.
1960年至1972年期间，330例卵巢癌患者中有276例接受了不同的术后放射治疗技术；54例晚期病例接受了前瞻性化疗。术后放射治疗选择腹腔内注射放射性金（190至300毫居里）、远距离钴治疗（5000拉德）或放射性金与远距离钴治疗联合使用。环磷酰胺（癌得星）、泼尼松龙和孕激素（普罗斯替尔）用于长期化疗。最成功的放射治疗技术与三年（五年）生存期后的长期化疗相对比：Ⅰa、b、c期：放射性金治疗=91.7%（66.7%），化疗（仅Ⅰc期）=100%。Ⅱa、b期：放射性金+远距离钴治疗=47%（35%），化疗=85%。Ⅲ期：放射性金+远距离钴治疗=25%（0%），化疗=52%。Ⅳ期：放射治疗=0%，化疗=25%。未经化疗的绝对五年生存率为23%。化疗情况下的死亡率曲线显示，如果在显微镜下检测到肿瘤细胞（腹水、大网膜），四年生存率为88%，但在肿瘤经肉眼证实后仅为30%。因此，建议在化疗开始前，对无法手术的阶段尽可能进行肿瘤部分切除术。只要肿瘤细胞有显微扩散的可能，建议在肉眼下手术完全切除后进行“预防性”长期化疗。在无法手术的阶段，化疗应在放射治疗之前应用。在Ⅰa、b、c期和Ⅱa期，建议术后用放射性金（100毫居里）进行照射，在Ⅱb期还应进行盆腔远距离放射治疗（6000拉德）。
