Kucera H, Sevelda P, Genger H, Weghaupt K
Geburtshilfe Frauenheilkd. 1985 Dec;45(12):848-52. doi: 10.1055/s-2008-1036488.
The importance of postoperative radiotherapy in patients with epithelial ovarian carcinomas was examined critically by means of our own results and the experiences published in international literature. 220 (36.2%) patients out of 608, whose inner genital tract could at least be partially removed, survived after irradiation therapy only without any chemotherapy. In FIGO stages I to III, without consideration of residual tumour mass, a survival rate of 73% after one year, 56% after two years, 47% after three years, 42% after four years and of 40% after five years after only postoperative irradiation therapy has been attained in the course of the last few years. To arrive at a useful comparison, several prognostic factors have to be considered in the estimation of therapeutic results of ovarian cancer. These prognostic factors are the non-resectable residual tumour mass, histology (cell type and grading), age of the patient and tumour stage (diagnosis, surgical technique, completeness of operation). Although our abdominal pelvic irradiation technique with 60-cobalt merely seems to be a compromise, we attained a remission rate and cure rate comparable to the results after postoperative chemotherapy. Our abdominal pelvic irradiation technique was well tolerated. The most frequent complication was an ileus (5.6%), whereas fistulas developed in 1.6% of all cases. According to the results of former randomised studies, postoperative irradiation is effective only in patients with residual tumour mass smaller than 2 cm, if an adequate irradiation technique could be performed. Hence, prospective chemotherapeutic studies should include a therapeutic arm with irradiation therapy alone or in combination with chemotherapy to clarify the importance of postoperative irradiation therapy in ovarian carcinomas.
通过我们自己的研究结果以及国际文献中发表的经验，对上皮性卵巢癌患者术后放疗的重要性进行了严格审查。在608例患者中，有220例（36.2%）患者的内生殖道至少可部分切除，仅接受放射治疗而未进行任何化疗后存活。在国际妇产科联盟（FIGO）分期为I至III期的患者中，不考虑残留肿瘤大小，在过去几年中，仅术后放疗一年后的生存率为73%，两年后为56%，三年后为47%，四年后为42%，五年后为40%。为了进行有效的比较，在评估卵巢癌的治疗效果时必须考虑几个预后因素。这些预后因素包括不可切除的残留肿瘤大小、组织学（细胞类型和分级）、患者年龄和肿瘤分期（诊断、手术技术、手术完整性）。虽然我们采用60钴的腹盆腔照射技术似乎只是一种折衷方案，但我们获得的缓解率和治愈率与术后化疗的结果相当。我们的腹盆腔照射技术耐受性良好。最常见的并发症是肠梗阻（5.6%），而所有病例中1.6%出现瘘管。根据以前随机研究的结果，如果能采用适当的照射技术，术后放疗仅对残留肿瘤小于2 cm的患者有效。因此，前瞻性化疗研究应包括一个单独放疗或放疗联合化疗的治疗组，以阐明术后放疗在卵巢癌中的重要性。
