Consolidation radiotherapy after carboplatin-based chemotherapy in radically operated advanced ovarian cancer

Objective. The aim of the study was to evaluate the effect of additional ra diotherapy after chemotherapy on the relapse-free and overall survival rate s of patients with advanced ovarian cancer. Methods. Between 1985 and 1992 64 patients with radically operated ovarian cancers (4 stage IC, 2 stage II, 54 stage III, and 4 stage IV) were enrolle d in a randomized study. Radical surgery comprised total abdominal hysterec tomy and bilateral salpingo-oophorectomy, omentectomy, and pelvic and paraa ortic lymphadenectomy. All patients received adjuvant chemotherapy with car boplatin IV 400 mg/m(2), epirubicin IV 70 mg/m(2) on day 1 and prednimustin e orally 100 mg/m(2) on days 3 to 7 at 1-month intervals. Thirty-two patien ts without residual disease were randomized to whole abdominal radiation (3 0 Gy, administered over 4 weeks). An additional 21.6 Gy were delivered to t he pelvis and 12 Gy to the paraaortic region up to the diaphragm for total doses of 51.6 and 42 Gy, respectively. Cancer-related survival was calculat ed with the Kaplan-Meier and Cox proportional hazards methods. Results. The relapse-free and overall survival rates of patients who receiv ed adjuvant chemoradiotherapy were significantly higher than those of patie nts who received adjuvant chemotherapy only (68% vs 56% at 2 years and 49% vs 26% at 5 years, P = 0.013, and 87% vs 61% at 2 years and 59% vs 33% at 5 years, P = 0.029). The differences were most pronounced in patients with s tage III disease (77% vs 54% at 2 years and 45% vs 19% at 5 years, P = 0.00 61, and 88% vs 58% at 2 years and 59% vs 26% at 5 years, P 0.012). Toxiciti es were acceptable. Conclusion. Sequential combination of platinum-based chemotherapy with open -field abdominal radiotherapy is a promising adjuvant regimen for patients with advanced ovarian cancer, (C) 1999 Academic Press.