Primary adjuvant whole abdominal irradiation in ovarian carcinoma

Abstract

Eighty-four patients with an ovarian carcinoma Stage I–III received an adjuvant whole abdominal irradiation (WAI) with pelvic boost postoperatively. Surgery included a bilateral salpingo-oophorectomy, hysterectomy, and omentectomy in 59% of the patients; in 41% surgery was less radical. For the whole abdominal irradiation we used the moving-strip method on 43 patients. The open-field technique was used on the other patients. Median dose of WAI was 22.5 Gy and median pelvic dose was 45.5 Gy. After a median follow-up of 68.5 months, a 5-year survival rate of 64 ± 5.7% was determined, as well as a 5-year NED rate of 61.2 ± 5.7%. Five-year survival rate was 80.1 ± 7.4% in Stage I, 64.1 ± 9.7% in Stage II, and 35.4 ± 11.6% in Stage III. Five-year survival depended on tumor rest significantly. There was a trend to better prognosis when surgery was complete and grade was G 1 or G 2. The risk factor according to Dembo proved to be the most reliable prognostic factor: the 5-year survival rates were 75.0 ± 6.3% for patients with intermediate risk and 20.1 ± 10.4% for those with high risk ( p = 0.001). Side effects were generally well tolerated. We only saw one serious complication, a radiation-induced small bowel obstruction.