Hacker N F, Berek J S, Burnison C M, Heintz P M, Juillard G J, Lagasse L D
Obstet Gynecol. 1985 Jan;65(1):60-6.
Thirty patients found to have residual epithelial ovarian cancer at second-look laparotomy were treated with whole abdominal radiation as salvage therapy. Dosage fractions were 120 rad per day until 3000 rad were delivered, then the pelvis was boosted to 5000 rad at 180 rad per day. Fourteen patients (47%) completed therapy without interruption and seven (23%) completed therapy with interruptions due to myelosuppression ranging from one to four weeks. Therapy was not completed in nine patients (30%). Four of 16 patients (25%) with microscopic residual disease before radiation remain alive and free of disease at 22 to 41 months. Two of six (33%) patients with minimal (less than or equal to 5 mm) residual disease remain alive and free of disease 19 to 40 months after radiation treatment. Patients with residual nodules greater than 5 mm uniformly did poorly. Patients who progressed on primary chemotherapy had a median survival of seven months, compared with more than 38 months for chemotherapy responders. Chronic bowel morbidity was a significant problem, with 30% of patients surviving at least four months from completion of radiation requiring laparotomy for small bowel obstruction. These preliminary results suggest that whole abdominal radiation may be useful in the management of patients who have responded to primary chemotherapy, but the benefit is confined to those patients who have minimal or microscopic disease at second-look laparotomy.
30例在二次剖腹探查时发现有残余上皮性卵巢癌的患者接受了全腹放疗作为挽救性治疗。剂量分割为每天120拉德，直至给予3000拉德，然后盆腔以每天180拉德的剂量增加至5000拉德。14例患者（47%）未中断完成治疗，7例患者（23%）因骨髓抑制中断1至4周后完成治疗。9例患者（30%）未完成治疗。16例放疗前有微小残留病灶的患者中有4例（25%）在22至41个月时仍存活且无疾病。6例微小（小于或等于5毫米）残留病灶的患者中有2例（33%）在放疗后19至40个月仍存活且无疾病。残留结节大于5毫米的患者预后均较差。接受一线化疗进展的患者中位生存期为7个月，而化疗反应者超过38个月。慢性肠道并发症是一个重要问题，30%从放疗结束后至少存活4个月的患者因小肠梗阻需要剖腹手术。这些初步结果表明，全腹放疗可能对一线化疗有反应的患者的治疗有用，但益处仅限于二次剖腹探查时有微小或显微镜下疾病的患者。
