复发性卵巢癌的放射治疗：累及野放射治疗的最新结果。

Radiotherapy in recurrent ovarian cancer: updated results of involved-field radiation therapy.

机构信息

Radiation Oncology, Uijeongbu St Mary's Hospital, Seoul, Korea (the Republic of).

Department of Radiation Oncology, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of).

出版信息

Int J Gynecol Cancer. 2023 Jul 3;33(7):1106-1111. doi: 10.1136/ijgc-2022-004200.

DOI:10.1136/ijgc-2022-004200

PMID:37217239

Abstract

OBJECTIVE

This study aimed to update the possible clinical benefits of radiation therapy in recurrent ovarian cancer.

METHODS

The medical records of 495 patients with recurrent ovarian cancer after initially undergoing maximal cytoreductive surgery and adjuvant platinum-based chemotherapy based on the pathologic stage between January 2010 and December 2020 were analyzed: 309 and 186 patients were treated without and with involved-field radiation therapy, respectively. Involved-field radiation therapy is defined as radiation therapy only to the areas of the body involved by tumor. The prescribed doses were ≥45 Gy (equivalent dose in 2 Gy/fraction). Overall survival was compared between patients treated with and without involved-field radiation therapy. The favorable group was defined as patients who satisfied at least four of the following factors: good performance, no ascites, normal CA-125, platinum-sensitive tumor, and nodal recurrence.

RESULTS

The median age of the patients was 56 years (range 49-63) and median time to recurrence was 11.1 months (range 6.1-15.5). 217 patients (43.8%) were treated at a single site. Radiation therapy, performance status, CA-125, platinum sensitivity, residual disease, and ascites were all significant prognostic factors. The 3-year overall survival of all patients, patients treated without radiation therapy, and patients treated with radiation therapy was 54.0%, 44.8%, and 69.3%, respectively. Radiation therapy was associated with higher overall survival rates in the unfavorable and favorable patient groups. Patient characteristics showed higher rates of normal CA-125, lymph node metastasis only, lower platinum sensitivity, and higher rates of ascites in the radiation therapy group. After propensity score matching, the radiation therapy group showed superior overall survival to the non-radiation therapy group. Normal CA-125, good performance status, and platinum sensitivity were associated with a good prognosis in patients treated with radiation therapy.

CONCLUSION

Our study showed that higher overall survival was observed in patients treated with radiation therapy in recurrent ovarian cancer.

摘要

目的

本研究旨在更新复发性卵巢癌行放疗的可能临床获益。

方法

分析了 2010 年 1 月至 2020 年 12 月间初次行最大程度减瘤术和辅助含铂化疗、按病理分期为Ⅰ期或Ⅱ期的 495 例复发性卵巢癌患者的病历资料：其中 309 例和 186 例患者分别未行和行累及野放疗，累及野放疗定义为仅对肿瘤累及的身体部位进行放疗。处方剂量≥45Gy（等效剂量为 2Gy/ 次）。比较行和未行累及野放疗患者的总生存率。将满足至少以下 4 个因素的患者定义为有利组：一般情况良好、无腹水、CA-125 正常、铂类敏感肿瘤和淋巴结复发。

结果

患者的中位年龄为 56 岁（范围 49-63 岁），中位复发时间为 11.1 个月（范围 6.1-15.5 个月）。217 例（43.8%）患者仅在一个部位复发。放疗、一般情况、CA-125、铂类敏感性、残留疾病和腹水均为显著预后因素。所有患者、未行放疗患者和行放疗患者的 3 年总生存率分别为 54.0%、44.8%和 69.3%。放疗与不利和有利患者组的较高总生存率相关。在放疗组，患者特征显示 CA-125 正常、仅淋巴结转移、铂类敏感性较低和腹水发生率较高的比例更高。在倾向评分匹配后，放疗组的总生存率优于非放疗组。在接受放疗的患者中，CA-125 正常、一般情况良好和铂类敏感性与良好预后相关。