Department of radiation oncology, Peking Union Medical College Hospital, Dongcheng District, Beijing, People's Republic of China.
Department of medical record, Peking Union Medical College Hospital, Dongcheng District, Beijing, People's Republic of China.
Cancer Control. 2024 Jan-Dec;31:10732748241263703. doi: 10.1177/10732748241263703.
For patients with stage III epithelial ovarian cancer, there are limited studies on the effects of postoperative adjuvant radiotherapy (RT). Here we assessed the therapeutic efficacy and toxicity of postoperative radiotherapy to the abdominal and pelvic lymphatic drainage area for stage III epithelial ovarian cancer patients, who had all received surgery and chemotherapy (CT).
We retrospectively collected patients with stage III epithelial ovarian cancer after cytoreductive surgery (CRS) and full-course adjuvant CT. The chemoradiotherapy (CRT) group patients were treated with intensity modulated radiotherapy (IMRT) to the abdominal and pelvic lymphatic drainage area in our hospital between 2010 and 2020. A propensity score matching analysis was conducted to compare the results between the CRT and CT groups. Kaplan-Meier analysis estimated overall survival (OS), disease-free survival (DFS), and local control (LC) rates. The log-rank test determined the significance of prognostic factors.
A total of 132 patients with median follow-up of 73.9 months (9.1-137.7 months) were included (44 and 88 for the CRT and RT groups, retrospectively). The baseline characteristics of age, histology, level of CA12-5, surgical staging, residual tumour, courses of adjuvant CT, and courses to reduce CA12-5 to normal were all balanced. The median DFS time, 5-year OS, and local recurrence free survival (LRFS) were 100.0 months vs 25.9 months ( = .020), 69.2% vs 49.9% ( = .002), and 85.9% vs 50.5% ( = .020), respectively. The CRT group mainly presented with acute haematological toxicities, with no statistically significant difference compared with grade III intestinal adverse effects (3/44 vs 6/88, = .480).
This report demonstrates that long-term DFS could be achieved in stage III epithelial ovarian cancer patients treated with IMRT preventive radiation to the abdominal and pelvic lymphatic area. Compared with the CT group, DFS and OS were significantly prolonged and adverse effects were acceptable.
对于 III 期上皮性卵巢癌患者，术后辅助放疗（RT）的效果有限。在这里，我们评估了对接受过手术和化疗（CT）的 III 期上皮性卵巢癌患者进行腹部和盆腔淋巴引流区术后放疗的治疗效果和毒性。
我们回顾性收集了在细胞减灭术（CRS）和全疗程辅助 CT 后患有 III 期上皮性卵巢癌的患者。CRT 组患者于 2010 年至 2020 年在我院接受强度调制放疗（IMRT）至腹部和盆腔淋巴引流区。采用倾向性评分匹配分析比较 CRT 组和 CT 组的结果。Kaplan-Meier 分析估计总生存期（OS）、无病生存期（DFS）和局部控制（LC）率。对数秩检验确定预后因素的显著性。
共纳入 132 例患者，中位随访时间为 73.9 个月（9.1-137.7 个月）（44 例 CRT 组和 88 例 CT 组）。年龄、组织学、CA12-5 水平、手术分期、残留肿瘤、辅助 CT 疗程和将 CA12-5 降低至正常的疗程等基线特征均平衡。中位 DFS 时间、5 年 OS 和局部无复发生存率（LRFS）分别为 100.0 个月 vs 25.9 个月（ =.020）、69.2% vs 49.9%（ =.002）和 85.9% vs 50.5%（ =.020）。CRT 组主要表现为急性血液学毒性，与 III 级肠道不良反应相比无统计学差异（3/44 比 6/88， =.480）。
本报告表明，III 期上皮性卵巢癌患者接受腹部和盆腔淋巴区预防性 IMRT 放疗可获得长期 DFS。与 CT 组相比，DFS 和 OS 显著延长，不良反应可接受。
