Lower abdominal radiotherapy for stages I, II, and selected III epithelial ovarian cancer: 20 years experience.

Between 1956 and 1975, lower abdominal radiotherapy was administered as primary postoperative treatment to 82 patients with stages I, II, and selected III epithelial ovarian carcinoma and with varying amounts of postoperative residual disease. The median follow-up was 7.5 years, and the overall freedom from relapse (FFR) at 10 years for the entire group was 57%. The FFR at 10 years for stages I, II, and III was 78, 60, and 24% respectively, and these results are better than published series of similarly staged patients treated with surgery alone. Ten-year FFR was 79% for patients with no residual disease (NRD), 49% for patients with minimal residual disease (MRD) of less than 2 cm, and 24% for patients with gross residual disease (GRD) of greater than 2 cm. Control within the irradiated lower abdomen was achieved in 97% of patients with NRD, 84% of patients with MRD, and in 55% of those with GRD. Of all relapses, 33% occurred in the pelvis (almost all in patients with GRD), 37% in the untreated upper abdomen, 21% in distant sites, and 9% had an undetermined intraabdominal site of relapse. Among those patients with stage I and II disease or favorable residual tumor (NRD and MRD), approximately 50% of relapses occurred in the untreated upper abdomen alone.