E Choan, Samant Rajiv, Fung Michael Fung Kee, Le Tien, Hopkins Laura, Senterman Mary
Division of Radiation Oncology, The Ottawa Hospital Regional Cancer Centre, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6.
Gynecol Oncol. 2006 Aug;102(2):406-10. doi: 10.1016/j.ygyno.2006.02.034. Epub 2006 May 2.
The role of radiotherapy for recurrent or residual granulosa cell tumor of the ovary (GCTO) is controversial. One reason for this controversy may be that most published studies on this topic have not utilized sectional imaging to assess response to radiotherapy. We report on three cases of recurrent or residual GCTO that were treated with radiotherapy for which pre- and post-treatment CT scans were available to assess response.
Case #1: A 77-year-old woman with a 7 x 10-cm pelvic mass post-surgery was treated with radiotherapy to a dose of 45 Gy in 25 fractions followed by a boost of 10 Gy in 5 fractions. Post-treatment scans revealed a decrease in tumor size to 4 x 2.5 cm. The reduction in tumor volume was 86%, and the duration of response was 13 months. Case #2: A 73-year-old woman with multiple abdominal recurrences was treated with radiotherapy to a dose of 30 Gy in 20 fractions. The dominant mass shrank from 13 x 17 cm to 5.1 x 6.6 cm. The reduction in volume was 85%, and the duration of response has been 5 months. Her symptom of abdominal bloating and early satiety abated. Case #3: An 83-year-old woman with a 20 x 20 x 15-cm mass in the left abdomen was treated with radiotherapy to a dose of 45 Gy in 25 fractions. The mass decreased in size to 3.7 x 2.5 cm post-treatment. The duration of response has been 21 months. Her symptom of left leg swelling disappeared after therapy.
Radiotherapy is highly effective in treating recurrent or residual GCTO. In these three cases, the tumor volume decreased by 85 to 90%, and the duration of response has, up to now, been 5 to 21 months.
放射治疗在复发性或残留性卵巢颗粒细胞瘤(GCTO)中的作用存在争议。造成这种争议的一个原因可能是,大多数关于该主题的已发表研究未使用断层成像来评估放射治疗的反应。我们报告了三例接受放射治疗的复发性或残留性GCTO病例,治疗前后均有CT扫描可用于评估反应。
病例1:一名77岁女性,术后盆腔有一个7×10 cm的肿块,接受放射治疗,剂量为45 Gy,分25次给予,随后追加10 Gy,分5次给予。治疗后扫描显示肿瘤大小缩小至4×2.5 cm。肿瘤体积缩小了86%,反应持续时间为13个月。病例2:一名73岁女性,腹部多处复发,接受放射治疗,剂量为30 Gy,分20次给予。主要肿块从13×17 cm缩小至5.1×6.6 cm。体积缩小了85%,反应持续时间为5个月。她腹部胀痛和早饱的症状减轻。病例3:一名83岁女性,左腹部有一个20×20×15 cm的肿块,接受放射治疗,剂量为45 Gy,分25次给予。治疗后肿块大小缩小至3.7×2.5 cm。反应持续时间为21个月。治疗后她左腿肿胀的症状消失。
放射治疗在治疗复发性或残留性GCTO方面非常有效。在这三例病例中,肿瘤体积减少了85%至90%,截至目前,反应持续时间为5至21个月。