Radiotherapy after chemotherapy and second-look laparotomy in the treatment of advanced ovarian cancers

In order to better assess the place of abdominopelvic irradiation after chemotherapy in the treatment of advanced ovarian carcinoma, the survival times in 25 patients treated from 1976 to 1986 were examined. 2 stage IIc, 18 stage III and 4 stage IV were treated. Treatment included chemotherapy (with cisplatin in 16/25 cases) and a second-look laparotomy. 12 patients had only microscopic residual tumor, 5 had macroscopic tumor less than 2 cm, and 8 patients had no detectable residual tumor. A whole abdomen irradiation of 22.50 Gy with a pelvic boost to 45 Gy was also performed. Actuarial 3-year survival was 58% for the entire population. 10 loco-regional relapses were observed. The 3-year-actuarial survival was 71% for stage III patients. Haematologic tolerance of irradiation was poor with only 17 patients (68%) receiving the complete dose of irradiation. One late grade 3 intestinal complication was observed. These results and others previously published, suggest that abdominal irradiation is valuable in the treatment of advanced ovarian carcinoma for stage IIc or III patients without macroscopic residual disease after chemotherapy and second-look laparotomy.