Intensity modulated radiation therapy for recurrent ovarian cancer refractory to chemotherapy

Anupama Chundury, Anthony Apicelli, Todd DeWees, Matthew Powell, David Mutch, Premal Thaker, Clifford Robinson, Perry W. Grigsby, Julie K. Schwarz

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective To evaluate local control, survival outcomes, and toxicity after intensity modulated radiotherapy (IMRT) for recurrent chemorefractory ovarian cancer. Methods Between 2006 and 2014, 33 patients were treated with IMRT for recurrent ovarian cancer. Patients received a median of 3 chemotherapy regimens prior to IMRT (range, 1-12) with 11 (33%) undergoing concurrent therapy. Local control (LC), recurrence free survival (RFS), and overall survival (OS) were calculated via Kaplan-Meier method. Toxicity was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v4.03. Impact of patient characteristics on outcomes was evaluated via Cox's proportional hazard model. Results Median follow up was 23.7 months. Forty-nine sites were treated to a median dose of 5040 cGy (range, 4500-7000). Nine (18%) of the 49 sites had in-field failures. Two year actuarial LC, RFS, and OS were 82%, 11%, and 63%, respectively. Seventeen patients had both a pre and post-treatment FDG-PET/CT; 6 (35%) had a complete metabolic response while 11 (65%) had a partial metabolic response. Acute ≥ grade 3 gastrointestinal (GI) toxicities occurred in 2 (6%) patients, late ≥ grade 3 GI toxicities occurred in 12 (36%), acute ≥ grade 3 hematological toxicities occurred in 5 (15%) and late ≥ grade 3 hematological toxicities occurred in 14 (42%). Conclusions IMRT for recurrent chemorefractory ovarian cancer is associated with excellent local control and limited radiation related toxicity. Future studies will be required to determine which subpopulation will benefit most from IMRT and whether alternative techniques such as stereotactic body radiotherapy may be feasible.

Original languageEnglish (US)
Pages (from-to)134-139
Number of pages6
JournalGynecologic Oncology
Volume141
Issue number1
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

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Intensity-Modulated Radiotherapy
Ovarian Neoplasms
Radiotherapy
Drug Therapy
Survival
Recurrence
Radiosurgery
Proportional Hazards Models
Terminology
Radiation
Therapeutics

Keywords

  • Ovarian
  • Radiotherapy
  • Recurrent

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Intensity modulated radiation therapy for recurrent ovarian cancer refractory to chemotherapy. / Chundury, Anupama; Apicelli, Anthony; DeWees, Todd; Powell, Matthew; Mutch, David; Thaker, Premal; Robinson, Clifford; Grigsby, Perry W.; Schwarz, Julie K.

In: Gynecologic Oncology, Vol. 141, No. 1, 01.04.2016, p. 134-139.

Research output: Contribution to journalArticle

Chundury, A, Apicelli, A, DeWees, T, Powell, M, Mutch, D, Thaker, P, Robinson, C, Grigsby, PW & Schwarz, JK 2016, 'Intensity modulated radiation therapy for recurrent ovarian cancer refractory to chemotherapy', Gynecologic Oncology, vol. 141, no. 1, pp. 134-139. https://doi.org/10.1016/j.ygyno.2016.02.005
Chundury, Anupama ; Apicelli, Anthony ; DeWees, Todd ; Powell, Matthew ; Mutch, David ; Thaker, Premal ; Robinson, Clifford ; Grigsby, Perry W. ; Schwarz, Julie K. / Intensity modulated radiation therapy for recurrent ovarian cancer refractory to chemotherapy. In: Gynecologic Oncology. 2016 ; Vol. 141, No. 1. pp. 134-139.
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abstract = "Objective To evaluate local control, survival outcomes, and toxicity after intensity modulated radiotherapy (IMRT) for recurrent chemorefractory ovarian cancer. Methods Between 2006 and 2014, 33 patients were treated with IMRT for recurrent ovarian cancer. Patients received a median of 3 chemotherapy regimens prior to IMRT (range, 1-12) with 11 (33{\%}) undergoing concurrent therapy. Local control (LC), recurrence free survival (RFS), and overall survival (OS) were calculated via Kaplan-Meier method. Toxicity was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v4.03. Impact of patient characteristics on outcomes was evaluated via Cox's proportional hazard model. Results Median follow up was 23.7 months. Forty-nine sites were treated to a median dose of 5040 cGy (range, 4500-7000). Nine (18{\%}) of the 49 sites had in-field failures. Two year actuarial LC, RFS, and OS were 82{\%}, 11{\%}, and 63{\%}, respectively. Seventeen patients had both a pre and post-treatment FDG-PET/CT; 6 (35{\%}) had a complete metabolic response while 11 (65{\%}) had a partial metabolic response. Acute ≥ grade 3 gastrointestinal (GI) toxicities occurred in 2 (6{\%}) patients, late ≥ grade 3 GI toxicities occurred in 12 (36{\%}), acute ≥ grade 3 hematological toxicities occurred in 5 (15{\%}) and late ≥ grade 3 hematological toxicities occurred in 14 (42{\%}). Conclusions IMRT for recurrent chemorefractory ovarian cancer is associated with excellent local control and limited radiation related toxicity. Future studies will be required to determine which subpopulation will benefit most from IMRT and whether alternative techniques such as stereotactic body radiotherapy may be feasible.",
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AU - Thaker, Premal

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AU - Grigsby, Perry W.

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N2 - Objective To evaluate local control, survival outcomes, and toxicity after intensity modulated radiotherapy (IMRT) for recurrent chemorefractory ovarian cancer. Methods Between 2006 and 2014, 33 patients were treated with IMRT for recurrent ovarian cancer. Patients received a median of 3 chemotherapy regimens prior to IMRT (range, 1-12) with 11 (33%) undergoing concurrent therapy. Local control (LC), recurrence free survival (RFS), and overall survival (OS) were calculated via Kaplan-Meier method. Toxicity was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v4.03. Impact of patient characteristics on outcomes was evaluated via Cox's proportional hazard model. Results Median follow up was 23.7 months. Forty-nine sites were treated to a median dose of 5040 cGy (range, 4500-7000). Nine (18%) of the 49 sites had in-field failures. Two year actuarial LC, RFS, and OS were 82%, 11%, and 63%, respectively. Seventeen patients had both a pre and post-treatment FDG-PET/CT; 6 (35%) had a complete metabolic response while 11 (65%) had a partial metabolic response. Acute ≥ grade 3 gastrointestinal (GI) toxicities occurred in 2 (6%) patients, late ≥ grade 3 GI toxicities occurred in 12 (36%), acute ≥ grade 3 hematological toxicities occurred in 5 (15%) and late ≥ grade 3 hematological toxicities occurred in 14 (42%). Conclusions IMRT for recurrent chemorefractory ovarian cancer is associated with excellent local control and limited radiation related toxicity. Future studies will be required to determine which subpopulation will benefit most from IMRT and whether alternative techniques such as stereotactic body radiotherapy may be feasible.

AB - Objective To evaluate local control, survival outcomes, and toxicity after intensity modulated radiotherapy (IMRT) for recurrent chemorefractory ovarian cancer. Methods Between 2006 and 2014, 33 patients were treated with IMRT for recurrent ovarian cancer. Patients received a median of 3 chemotherapy regimens prior to IMRT (range, 1-12) with 11 (33%) undergoing concurrent therapy. Local control (LC), recurrence free survival (RFS), and overall survival (OS) were calculated via Kaplan-Meier method. Toxicity was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v4.03. Impact of patient characteristics on outcomes was evaluated via Cox's proportional hazard model. Results Median follow up was 23.7 months. Forty-nine sites were treated to a median dose of 5040 cGy (range, 4500-7000). Nine (18%) of the 49 sites had in-field failures. Two year actuarial LC, RFS, and OS were 82%, 11%, and 63%, respectively. Seventeen patients had both a pre and post-treatment FDG-PET/CT; 6 (35%) had a complete metabolic response while 11 (65%) had a partial metabolic response. Acute ≥ grade 3 gastrointestinal (GI) toxicities occurred in 2 (6%) patients, late ≥ grade 3 GI toxicities occurred in 12 (36%), acute ≥ grade 3 hematological toxicities occurred in 5 (15%) and late ≥ grade 3 hematological toxicities occurred in 14 (42%). Conclusions IMRT for recurrent chemorefractory ovarian cancer is associated with excellent local control and limited radiation related toxicity. Future studies will be required to determine which subpopulation will benefit most from IMRT and whether alternative techniques such as stereotactic body radiotherapy may be feasible.

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