Komura Naoko, Mabuchi Seiji, Isohashi Fumiaki, Yokoi Eriko, Shimura Kotaro, Matsumoto Yuri, Kodama Michiko, Tomimatsu Takuji, Ogawa Kazuhiko, Kimura Tadashi
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
J Obstet Gynaecol Res. 2019 Jun;45(6):1173-1182. doi: 10.1111/jog.13947. Epub 2019 Mar 6.
To evaluate the efficacy and toxicity of external beam radiotherapy (RT) for isolated recurrent epithelial ovarian cancer (EOC).
Twenty-four isolated recurrent EOC patients treated with RT at Osaka University Hospital between January 2000 and January 2017 were included in the current study. Data regarding the primary or recurrent diseases, follow-up findings, and efficacy or toxicities of RT were collected and retrospectively analyzed. Survival rates were calculated using the Kaplan-Meier method and compared using the log-rank test.
Their median age was 59 years. Most patients had International Federation of Gynecology and Obstetrics stage III-IV diseases at the initial diagnosis. Histologically, serous adenocarcinoma was predominant, followed by clear cell adenocarcinoma. All patients had received at least one regimen of platinum-based chemotherapy; 8 were platinum-sensitive relapse and the others were platinum-resistant. Lymph nodes were the most common sites of recurrence, and the median tumor size was 25.5 mm. The median total dose of RT administered was 54 Gy, with a median daily dose of 2 Gy. RT was well-tolerated, and no patients experienced Grade 3/4 toxicities. The in-field overall response rate was 58.3% (14/24), the median regression rate was -40.2% (range: -100 to 0) and the median survival period after RT was 17 months. The 1-year survival and local progression-free survival rates after RT were 66.7% and 45.8%, respectively.
RT showed significant antitumor effect against isolated recurrent EOC without causing severe toxicities. Prospective studies with sufficient statistical power are warranted to further evaluate the role of RT in this patient population.
评估体外放疗（RT）治疗孤立性复发性上皮性卵巢癌（EOC）的疗效和毒性。
纳入2000年1月至2017年1月在大阪大学医院接受RT治疗的24例孤立性复发性EOC患者。收集有关原发性或复发性疾病、随访结果以及RT疗效或毒性的数据，并进行回顾性分析。采用Kaplan-Meier法计算生存率，并使用对数秩检验进行比较。
患者的中位年龄为59岁。大多数患者在初始诊断时为国际妇产科联盟III-IV期疾病。组织学上，浆液性腺癌为主，其次是透明细胞腺癌。所有患者均接受过至少一种铂类化疗方案；8例为铂敏感复发，其余为铂耐药。淋巴结是最常见的复发部位，中位肿瘤大小为25.5mm。RT的中位总剂量为54Gy，中位每日剂量为2Gy。RT耐受性良好，无患者出现3/4级毒性。野内总缓解率为58.3%（14/24），中位退缩率为-40.2%（范围：-100至0），RT后的中位生存期为17个月。RT后的1年生存率和局部无进展生存率分别为66.7%和45.8%。
RT对孤立性复发性EOC显示出显著的抗肿瘤作用，且未引起严重毒性。有必要进行具有足够统计学效力的前瞻性研究，以进一步评估RT在该患者群体中的作用。
