Macchia Gabriella, Titone Francesca, Restaino Stefano, Arcieri Martina, Pellecchia Giulia, Andreetta Claudia, Driul Lorenza, Vizzielli Giuseppe, Pezzulla Donato
Radiation Oncology Unit, Responsible Research Hospital, 86100 Campobasso, Italy.
Radiation Oncology Unit, Department of Oncology, "Santa Maria della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy.
Healthcare (Basel). 2023 Aug 28;11(17):2413. doi: 10.3390/healthcare11172413.
With a 5-year survival rate of fewer than 50%, epithelial ovarian carcinoma is the most fatal of the gynecologic cancers. Each year, an estimated 22,000 women are diagnosed with the condition, with 14,000 dying as a result, in the United States. Over the last decade, the advent of molecular and genetic data has enhanced our understanding of the heterogeneity of ovarian cancer. More than 80% of women diagnosed with advanced illness have an initial full response to rigorous therapy at diagnosis, including surgery and platinum-based chemotherapy. Unfortunately, these responses are infrequently lasting, and the majority of women with ovarian cancer suffer recurrent disease, which is often incurable, despite the possibility of future response and months of survival. And what therapeutic weapons do we have to counter it? For many years, radiation therapy for ovarian tumors was disregarded as an effective treatment option due to its toxicity and lack of survival benefits. Chemotherapy is widely used following surgery, and it has nearly completely supplanted radiation therapy. Even with the use of more modern and efficient chemotherapy regimens, ovarian cancer failures still happen. After receiving first-line ovarian cancer chemotherapy, over 70% of patients show evidence of recurrence in the abdomen or pelvis. It is necessary to reinterpret the function of radiation therapy in light of recent technological developments, the sophistication of radiation procedures, and the molecular and biological understanding of various histological subtypes. This review article focuses on the literature on the use of radiation in ovarian tumors as well as its rationale and current indications.
上皮性卵巢癌的5年生存率低于50%，是最致命的妇科癌症。在美国，每年估计有22000名女性被诊断出患有这种疾病，其中14000人因此死亡。在过去十年中，分子和基因数据的出现加深了我们对卵巢癌异质性的理解。超过80%被诊断为晚期疾病的女性在诊断时对包括手术和铂类化疗在内的严格治疗有初始完全反应。不幸的是，这些反应很少能持久，大多数卵巢癌女性会复发，尽管有可能再次缓解并存活数月，但往往无法治愈。我们有哪些治疗手段来应对它呢？多年来，由于其毒性和缺乏生存益处，卵巢肿瘤的放射治疗一直被视为一种无效的治疗选择。化疗在手术后被广泛使用，几乎完全取代了放射治疗。即使使用更现代、更有效的化疗方案，卵巢癌治疗失败仍会发生。在接受一线卵巢癌化疗后，超过70%的患者出现腹部或盆腔复发迹象。有必要根据最近的技术发展、放射治疗程序的复杂性以及对各种组织学亚型的分子和生物学理解，重新审视放射治疗的作用。这篇综述文章重点关注关于卵巢肿瘤放射治疗的文献及其理论依据和当前适应证。
