Image-guided intensity-modulated whole abdominal radiation therapy in relapsed epithelial ovarian cancers: a feasibility study.

Background and Purpose: Advanced epithelial ovarian cancer is associated with high relapse rates. Various consolidative therapies, including whole abdominal radiation therapy (WAR), have been tried in the past with limited success. We report here a feasibility study and clinical outcome of WAR with helical tomotherapy (HT).
Materials and Methods: Eight patients with relapsed carcinoma ovary after standard treatment and deemed not suitable for further chemotherapy were treated with WAR using HT. All patients underwent intensity-modulated radiotherapy (IMRT) planning process and a dose of 25 Gy/25#, at 1 Gy/# to the whole of the abdomen [abdominal planning treatment volume (PTV)] with a simultaneous boost of 45 Gy/25#, at 1.8 Gy/# to the pelvic PTV was prescribed.
Results: There was an excellent coverage in both abdominal and pelvic PTVs.The V 95% (volume covered by the 95% isodose) and V 107% (volume receiving 107% dose) was 95.6 (± 2.7)% and 2.6 (± 0.5)% for abdominal PTV and 95.7 (± 2.4)% and 0% for pelvic PTV, respectively. With a median follow-up of 15 months (10-24 months, mean: 14 months), 3 patients developed disease recurrence. All 3 recurred in the peritoneum, one progressed to intestinal obstruction and fatal septicemia.
Conclusion: WAR in recurrent/relapsed epithelial ovarian cancer is feasible with acceptable toxicities.