ABDOMINO PELVIC IRRADIATION AFTER 2ND-LOOK LAPAROTOMY FOR STAGE-III OVARIAN-CARCINOMA

Objective: The purpose of this retrospective analysis of 34 patients w ith stage III ovarian carcinoma was to review results and morbidity of whole abdominal irradiation after surgery and chemotherapy. Methods a nd materials: All of the 34 patients had reached a complete clinical r emission after first cytoreductive surgery and chemotherapy. After sec ond-look laparotomy each patient underwent whole abdominal irradiation . Except for two patients with chronic myelosuppression, the dose admi nistered was of 22.5 Gy to the abdominal cavity with a boost of 22.5 G y added to the pelvis. Results: Three and 5-year overall survival rate s were 62% and 43%, respectively. Three and 5-year disease-free surviv al rates were 53% and 38%. Twenty-three patients (68%) developed local relapse or local disease progression. Metastasis occurred in five cas es and were always associated with an abdominal cavity recurrence. Res idual disease after first cytoreductive surgery appeared as a prognost ic factor in univariate analysis. Patients with unresected residuum ha d a 5-year survival probability of 35% versus 83% for patients without residual disease. We observed 12% grade-3 intestinal toxicities and o ne fatal case of radiation enteritis. Conclusion: Despite its curative potential, the long term benefit of whole abdominal irradiation in th e multimodality treatment of advanced ovarian carcinoma must be evalua ted in well designed controlled trials.