Rome R, et al. - Factors linked to long-term disease-specific survival (DSS) and complications following radiotherapy (RT) for recurrent or persistent ovarian and tubal cancer were investigated in this analysis. Data reported that in select cases of localized recurrent or persistent ovarian cancer, there was a place for RT and it might confer long-term survival. Though it might confer an increased risk of severe bowel complications, it was noted that surgery was useful to debulk and define the extent of tumor to be irradiated.

Methods

• For this investigation, 65 women with ovarian (57), tubal (3), or co-existent ovarian/endometrial carcinoma (5) received RT (> 45 Gy) with curative intent for recurrent (45) or persistent cancer (20) found at second-look surgery between 1980 and 2015.
• Surgery to debulk (± restage) was incorporated into the management of all but seven cases.

Results

• The study results showed that 22 women had no evidence of disease at last contact after a median of 15.6 years (range=1.0–35.8 years).
• Out of 53 subjects treated more than 10 years ago, 18 (34%) are in this long-term no evidence of disease group.
• Univariate analysis demonstrated that the following factors were significantly linked with longer DSS (P < 0.05): initial stage I, II (vs III, IV); endometrioid histology (vs serous and other); no or 1 previous chemotherapy (vs ≥ 2); no macroscopic tumor before RT (vs macroscopic); localized tumor encompassed by a limited-volume RT field (vs more widespread tumor), and chemotherapy and RT (vs RT only).
• Multivariate analysis demonstrated that endometrioid (vs other histology HR = 4.37, P=0.017) and localized tumor (vs more widespread tumor, HR = 2.43, P=0.017) were significantly linked with longer DSS.
• Data reported that 13 (21.7%) of 60 subjects developed G3 or 4 bowel complications requiring surgery after RT to the pelvis and/or abdomen; in 10, these occurred in the presence of tumor, RT changes, and adhesions, and in 3, no sign of cancer was found.
• According to the findings obtained, six patients (9.2%) developed a subsequent malignancy.