Simultaneous radio-chemotherapy of advanced epithelial ovarian cancer - results after three year

An interdisciplinary prospective, non-randomized study was perfomed at the University Clinic for Radiotherapy and Radiobiology of Vienna in 26 patients with advanced epithelial ovarian cancers (FIGO stage 3 and 4) from February 1977 until February 1980. All patients underwent a combined radiotherapy - chemotherapy programme. In those 12 patients in whom at the time of the first operation only a biopsy was possible, the aim was to achieve early operability for a second-look operation (with removal of the internal reproductive organs, the omentum and remaining tumour masses). In 8 of these 12 patients it was technically possible to perform radical surgery or to reduce tumour masses to under 2 cm. Of 20 evaluable patients 14 had stage 3 and 6 had stage 4 cancer. In patients with stage 3 the response rate was 100% and the complete remission rate (with or without second-look operation) was above 70%. The duration of complete remission exceeded 10 months, median survival is at present 17 months. Patients with stage 4 had a response rate of 66% (but mainly partial remissions), with significantly shorter survival times. Bowel complications occurred in one quarter of the patients and led to a revision of our therapeutic concept and the time sequence of the combined modality treatment. The importance of significant prognostic factors is stressed. The study indicated the superiority of the combined treatment approach in patients with stage 3 cancer. Patients with stage 4 cancer are, on the other hand, best managed primarily by chemotherapy; palliative irradiation and a second-look operation should be reserved only for selected patients. (author)