Radiotherapy in Ovarian Cancer for Post-Surgical Minimal Residual Disease

  • D. Chassagne
  • J. P. Wolff
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 68)

Abstract

In ovarian carcinomas more than in any other solid tumor, post-surgical minimal residual disease is difficult to define precisely and this definition may differ according to stage. In stage I (A, B, and C) there is a possibility of malignant cells being left behind in the peritoneal cavity. Centrifugation of the peritoneal washings during and at the end of surgery can show the presence of cancer cells in numerous cases [2–4], but this “positive” finding does not prove that a subsequent seeding of “cancer colonies” is inevitable. However, these facts explain at least partially a 20% incidence of failure in stage I and therefore may justify an additive therapy in stage I. In stage IIA or IIB, the above may apply, but there is also the possibility of microscopic residual disease, especially around the peritoneal suture line. In addition, for stage IIB the residual disease may range from an implant a few millimeters in size to a bulky unresectable tumor. The definition of minimal residual disease is, therefore, impossible to give precisely, unless a size of residual macrosopic disease is stated and widely accepted.

Keywords

Phosphorus Oncol Melphalan Cyclophosphamide Washing 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Reference

  1. 1.
    Aldermann, S. J., Dillon, T. F., Krummerman, M. S., Phillips, B. P., Chung, A. F.: Post-operative use of radioactive phosphorus in stage I ovarian carcinoma. Obstet. Gynecol. 49, 659–662 (1977).Google Scholar
  2. 2.
    Barber, H. R., Kwon, T. H.: Current status of the treatment of gynecologic cancer by site-ovary. Cancer 38, 610–619 (1976).PubMedCrossRefGoogle Scholar
  3. 3.
    Brady, L. W.: Future prospect of radiotherapy in gynecologic oncology. Cancer [Suppl. 1] 38, 553–565 (1976).Google Scholar
  4. 4.
    Brady, L. W.: Combined modality therapy of gynecologic cancer. Cancer 35, 76–83 (1975).PubMedCrossRefGoogle Scholar
  5. 5.
    Bush, R. S., Allt, W. E., Beale, F. A., Bean, H., Pringle, J. F.: Treatment of epithelial carcinoma of the ovary: operation, irradiation and chemotherapy. Am. J. Obstet. Gynecol. 127, 692–704 (1977).PubMedGoogle Scholar
  6. 6.
    Chassagne, D.: Résultats et indications de la radiothérapie dans le cancer de l’ovaire. Louvain Med. 90, 541–549 (1971).Google Scholar
  7. 7.
    Clark, D. G. C., Hilaris, B. S., Roussis, C. et al.: The role of radiation therapy (including isotopes) in the treatment of cancer of the ovary (results of 614 patients treated at Memorial Hospital New York. In: Clinical cancer. Ariel, I. M. (ed.), Vol. 5, pp. 227-235. New York: Grune and Stratton 1973.Google Scholar
  8. 8.
    Dargent, M., Dargent, D., Lansac, J.: Traitement des tumeurs malignes primitives de l’ovaire. Etude rétrospective de 349 observations recueillies entre 1946 et 1966 au Centre Anti-Cencéreux de Lyon. J. Gynecol. Obstet. Biol. Reprod. (Paris) 2, 421–431 (1972).Google Scholar
  9. 9.
    Delclos, L., Smith, J. P.: Ovarian cancer with special regards to types of radiotherapy. Natl. Cancer Inst. Monogr. 42, 129–135 (1975).PubMedGoogle Scholar
  10. 10.
    Fazekas, V. T., Maier, V. G.: Irradiation of ovarian carcinomas. A prospective comparison of the open field and moving-strip techniques. Am. J. Roentgenol. 120, 118–123 (1974).Google Scholar
  11. 11.
    Fisher, R. I., Young, R. C.: Advances in the staging and treatment of ovarian cancer. Cancer 39, 967–972 (1977).PubMedCrossRefGoogle Scholar
  12. 12.
    Fuks, Z.: External radiotherapy of ovarian cancer: standard approaches and new frontiers. Semin. Oncol. 2, 253–266 (1975).PubMedGoogle Scholar
  13. 13.
    Fuks, Z.: The role of radiation therapy in the management of ovarian carcinoma. Jor. J. Med. Sci. 13, 815–828 (1977).Google Scholar
  14. 14.
    Gladstein, E., Fuks, Z., Bagshaw, M. A.: Diaphragmatic treatment in ovarian carcinoma: a new radiotherapeutic technique. Int. J. Radiat. Oncol. Biol. Phys. 2, 357–362 (1977).CrossRefGoogle Scholar
  15. 15.
    Henderson, D.: Cancer of the ovary. Proceed. Annu. Clin. Conf. Cancer Ov. Windsor (Ontario), 1965. pp. 149-159.Google Scholar
  16. 16.
    Hintz, B. L., Fuks, Z., Kempson, R. L., Eltringham, J., Zalovdek, C., Williamson, T. J., Bagshaw, M. A.: Results of post-operative megavoltage radiotherapy of malignant surface epithelial tumors of the ovary. Radiology 114, 695–700 (1975).PubMedGoogle Scholar
  17. 17.
    Hreschchyshyn, M. M.: Results of gynecologic oncology group trials on ovarian cancer: Preliminary report. Natl. Cancer Inst. Monogr. 42, 115–165 (1975).Google Scholar
  18. 18.
    Johnson, C. F., Decker, D. G., Van Herick, M. et al.: Advanced ovarian cancer: therapy with radiation and cyclophosphamide in a random series. Am. J. Roentgenol. 114, 136–141 (1972).Google Scholar
  19. 19.
    Michel, G., Prade, M., Charpentier, P.: Intérêt de l’omentectomie systématique chez les malades porteuses de tumeurs malignes de l’ovaire. Gynecol. 27, 455–457 (1976).Google Scholar
  20. 20.
    Muller, H. H.: Curative aim and results of routine intraperitoneal radio-colloid administration in the treatment of ovarian cancer. Am. J. Roentgenol. 89, 533–540 (1963).Google Scholar
  21. 21.
    Piver, M. S., Lopez, R. G., Xynos, F., Barlow, J. J.: The value of pre-therapy peritoneoscopy in localized ovarian cancer. Am. J. Obstet. Gynecol. 127, 288–290 (1977).PubMedGoogle Scholar
  22. 22.
    Rosenoff, S. H., De Vita, V. T., Hubbard, S., Young, R. C.: Peritoneoscopy in the staging and follow-up of ovarian cancer. Semin. Oncol. 2, 223–228 (1975).PubMedGoogle Scholar
  23. 23.
    Rubin, P.: Understanding the problem of understaging in ovarian cancer. Semin. Oncol. 2, 235–242 (1975).PubMedGoogle Scholar
  24. 24.
    Sack, H.: Die Strahlenbehandlung der Ovarialtumoren. Strahlentherapie 153, 319–324 (1976).Google Scholar
  25. 25.
    Smith, J. P., Rutledge, F. N., Delclos, L.: Results of chemotherapy as an adjunct to surgery in patients with localized ovarian cancer. Semin. Oncol. 2, 277–282 (1975).PubMedGoogle Scholar
  26. 26.
    Underwood, P. B., Merrit, J. O., Hitz, L. H., Wallence, K. H., Marks, R. D.: Carcinoma of the ovary: the adjunctive use of irradiation. Gynecol. Oncol. 3, 298–307 (1976).CrossRefGoogle Scholar
  27. 27.
    Wallner, P. E., Brady, L. W., Lewis, G. C. (Jr.), Nuss, R. C.: Post-operative pelvic irradiation of stage II ovarian carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2, 281–288 (1977).PubMedCrossRefGoogle Scholar
  28. 28.
    Wolff, J. P., Weill, S., Dergelet, L.: Cancer de l’ovaire. Etude clinique et pronostique. 6th International Congress of Gynecology and Obstetrics. New York, April 1970.Google Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1979

Authors and Affiliations

  • D. Chassagne
  • J. P. Wolff

There are no affiliations available

Personalised recommendations