Individualized treatment of ovarian cancer

Abstract

During the years 1968 to 1974, 418 patients with Stage I and Stage II malignant epithelial tumors of the ovary entered a controlled clinical trial. The purpose was to compare the results of postoperative external irradiation with intraperitoneal instillation of radioactive colloidal gold (Au198). The Stage I series comprised 175 invasive carcinomas and 83 tumors of low potential malignancy. The Stage II series comprised 160 invasive carcinomas and five cases of potentially malignant tumors. No significant difference in the five-year survival rate was found for the patients with Stage I lesions. A lower number of cancer deaths among those treated with Au198 was outweighed by a higher number of deaths from complications. However, patients with Stage IA serous and mucinous tumors, Stage IB and IC tumors (all histologic types), and ruptured tumors did significantly better when treated with Au198. The five-year survival rate for patients with Stage II lesions treated with gold was 54.1 per cent as compared to 40.0 per cent for those receiving external irradiation. In agreement with these observations, a new treatment protocol is proposed which includes a randomized trial to study the value of adjuvant chemotherapy.