Clinical Analysis Of 20 Cases With Intensity-modulated Conformal Radiotherapy Plus Chemotherapy For Recurrent Epithelial Ovarian Cancer

Objective:The purpose of this study aimed to evaluate the clinical efficacy and toxicity of intensity-modulated conformal radiotherapy plus chemotherapy for the recurrence of epithelial ovarian cancer.Methods:This was a retrospective study of 40 patients with recurrent epithelial ovarian cancer at the Shanxi Tumour Hospital between January 2010 and January 2015. Of these 40 patients,20 underwent simple chemotherapy(control group),whereas the remaining 20 underwent intensity-modulated conformal radiotherapy plus chemotherapy(experimental group). Docetaxel(30mg/m2) was aintravenously administered 1、18、15、22、27、29and 36 days form the chemotherapy in the control group,and according to the patients used platinum drugs, we choosed carboplatin(AUC=5-6) or cisplatin 70mg/m2 or lobaplatin 30mg/m2 or oxaliplatin 130mg/m2 intravenous drip the first day and eighth day of the course, with a cycle of 8 weeks,after two to three course of chemotherapy,evaluate the recent efficacy and toxicity. Experimental group first used the 6 MV- X ray intensity-modulated conformal radiotherapy synchronize chemotherapy(the chemotherapy drug usage and dose same to the control group). PTV’s prescribed dose was 41-63 Gy, median dose was 53.5 Gy, 1.8-2.0 Gy/time/day, 5 times per week.After two to three course of chemotherapy, evaluate its efficacy and toxicity.Result:Control group complete remission 3 cases(15%),partial in5 cases(25%),stabitity 4cases(20%),progress in 8 cases(40%),effective rate was 40%;Experimental group complete remission 9 cases(45%), partial remission 6 cases(30%), stable 2 cases(10%),progress in 3 cases(15%),effective rate was 75%. Significant differences between two groups of efficient were indicated(c2=5.01, p<0.05).Median survival in the control group was 7.8 months,while the experimental group was 19.3 months,two groups showed significant difference(c2=3.869, p<0.05).Control group in leukopenia 13 cases(65%),I-II degrees 11 cases(50%),III-IV degrees 3 cases(15%);Hemoglobin and platelet was decreased,mainly for I-II degrees,account for 13 cases(65.5%)、4cases(20%)respectively;Experimental group in leukopenia 16cases(75%),I-II degrees 11cases(55%),III-IV degrees 5 cases(25%);Hemoglobin and platelet was decreased too,mainly for I-II degrees,account for 11 cases(60%)、5cases(20%)respectively。The difference between two groups in bone marrow obstruction was no significant(c2=0.11,p>0.05).The incidence of gastrointestinal toxicities in the control group was 20%(4cases),compared with experimental group 15%(3 cases),there was no statistic difference between the two groups(c2=0.17,p>0.05).Control group liver damage incidence was10%(2 cases),while the experimental group was 15%(3 cases),there was no statistic difference between the two groups(c2=0.23,p>0.05).Control group kidney damage incidence was 5%(1 case),while the experimental group was 10%(2 cases),there was no statistic difference between the two groups(c2=0.37,p>0.05).Conclusion:Intensity-modulated conformal radiotherapy in combination with chemotherapy in the treatment of recurrent epithelial ovarian cancer that occurred in vaginal stump、abdominopelvic wall and lymph nodes,the results enhanced short-time effects、extended overall survival and tolerable toxicity(such as bone marrow obstruction、gastrointestinal toxicities) compared with simple chemotherapy.So,it can be used patients.