Is there a place for whole abdominal radiotherapy in the management of ovarian cancer?

Abstract

Most patients with ovarian cancer require further therapy with chemotherapy or radiotherapy because of the high recurrence risk following surgery alone. Radiotherapy directed to the whole abdomen and pelvis is capable of producing survival rates of 70% in carefully selected patients. Such patients have no more than microscopic residual disease in the abdomen, and small volume residual disease in the pelvis. They are selected based on a prognostic matrix which considers grade, stage and the presence of pelvic residual disease. With optimal radiotherapy technique, long term serious toxicity occurs in less than 5% of patients. Patients with macroscopic residual disease are treated with chemotherapy. Patients who obtain a complete response have been treated with consolidative whole abdominal radiotherapy, although the benefit of such an approach is unclear.