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Role of salvage radiotherapy for recurrent ovarian cancer
  1. Bong Kyung Bae1,
  2. Won Kyung Cho1,
  3. Jeong-Won Lee2,
  4. Tae-Joong Kim2,
  5. Chel Hun Choi2,
  6. Yoo-Young Lee2 and
  7. Won Park1
  1. 1Department of Radiation Oncology, Samsung Medical Center, Gangnam-gu, Seoul, Korea (Republic of)
  2. 2Department of Obstetrics and Gynecology, Samsung Medical Center, Gangnam-gu, Seoul, Korea (Republic of)
  1. Correspondence to Dr Won Park, Department of Radiation Oncology, Sungkyunkwan University School of Medicine, Suwon 06351, Korea (Republic of); wonro.park{at}samsung.com

Abstract

Objective This study aimed to report clinical outcomes of salvage radiotherapy for recurrent ovarian cancer and identify predictors of clinical outcomes.

Methods We retrospectively reviewed data of patients who received salvage radiotherapy for recurrent ovarian cancer between January 2011 and June 2021. Stereotactic body radiotherapy, involved-field radiotherapy with conventional fractionation, and non-involved-field radiotherapy with conventional fractionation were included in this study. Local failure-free survival, progression-free survival, chemotherapy-free survival, and overall survival were assessed. Additionally, potential prognostic factors for survival were analyzed.

Results A total of 79 patients were included with 114 recurrent lesions. The median follow-up was 18.3 months (range 1.7–83). The 2-year local failure-free survival, progression-free survival, chemotherapy-free survival, and overall survival rates were 80.7%, 10.6%, 21.2%, and 74.7%, respectively. Pre-radiotherapy platinum resistance (hazard ratio (HR) 3.326, p<0.001) and short pre-radiotherapy CA-125 doubling time (HR 3.664, p<0.001) were associated with poor chemotherapy-free survival. The 1-year chemotherapy-free survival rates of patients with both risk factors, a single risk factor, and no risk factor were 0%, 20.4%, and 53.5%, respectively. The difference between risk groups was statistically significant: low risk versus intermediate risk (p<0.001) and intermediate risk versus high risk (p<0.001).

Conclusions Salvage radiotherapy for recurrent ovarian cancer resulted in local control with improved chemotherapy-free survival in carefully selected patients. Our results suggest that the consideration of pre-radiotherapy platinum resistance and pre-radiotherapy CA-125 doubling time could help with patient selection.

  • Radiotherapy
  • Ovarian Cancer
  • Neoplasm Recurrence, Local

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors Conceptualization: WP. Data curation: BKB, WKC, CHC, TJK, YYL, and JWL. Formal analysis: BKB and WP. Investigation: BKB and WP. Methodology: BKB and WP. Project administration: BKB and WP. Manuscript writing – original draft: BKB and WP. Manuscript writing – review and editing: BKB, WKC, CHC, TJK, YYL, JWL, and WP. WP is responsible for the overall content as the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.