MODERATE-RISK OVARIAN-CANCER (STAGE-I, GRADE-2 - STAGE-II, GRADE-1 ORGRADE-2) TREATED WITH CISPLATIN CHEMOTHERAPY (SINGLE-AGENT OR COMBINATION) AND PELVI-ABDOMINAL IRRADIATION

We placed patients with invasive epithelial ovarian cancer into four d istinct prognostic groups: 'low', 'moderate', 'high' and 'extreme' ris k. The 'moderate-risk' group contained all residual negative, stage I and II patients with two exceptions: stage 1a or b, grade 1 cancers an d grade 3 cancers. They were treated with primary surgery, usually inc luding bilateral salpingo-oophorectomy, hysterectomy and omentectomy. Chemotherapy was then given (cisplatin at 100 mg m2 every 2 weeks for three cycles) followed by pelvi-abdominal irradiation (2250 cGy in 10 fractions to the pelvis and 2250 cGy in 22 fractions to the whole abdo men including pelvis). An early cohort with ascites or positive washin gs instead received six cycles of cisplatin and cyclophosphamide at 75 mg m2 and 600 mg m2 every 4 weeks with the same pelvi-abdominal irrad iation sandwiched between cycles 3 and 4. One-hundred and nine patient s were treated between November 1983 and December 1989. Median follow- up was 4.7 years (range 0.7-9 years). The 5-year actuarial overall and failure-free survivals were 81% and 76%, respectively. Chronic toxici ty, although usually minor, included 15% with peripheral neuropathy or ototoxicity and 23% with chronic abdominal complaints. Our combined-m odality results are similar to those obtained by other centers utilizi ng either pelvi-abdom-inal irradiation alone or cisplatin-based chemot herapy alone.