Clinical Value Of Whole Abdominal Intensity-modulated Radiotherapy For Staged ?/? Chemotherapy-resistant Recurrent Epithelial Ovarian Cancer

Objective:To evaluate the clinical efficacy and toxicity of whole abdominal intensity-modulated radiotherapy for chemotherapy-resistant advanced recurrent epithelial ovarian cancer.Methods:In this retrospective clinical study,44 patients who has confirmed pathologically as staged ? or ? chemotherapy-resistant recurrent epithelial ovarian cancer were enrolled in our hospital from December 1 2016 to November 1 2018.According to the diffierent treatment,recurrent patients who received initial treatment with optimal debulking surgery and adjuvant platinum-based chemotherapy were divided into experimental group and control group.Experimental group(21cases)received whole abdominal intensity-modulated radiotherapy:radiation type is6MV-Xray,radiation technology are IMRT/VMAT/TOMO,the total prescription radiation dose is 30Gy/20f/4w,the metastases are supplemented to 45Gy/20f/4w additionally.The organ at risk(OAR)concluded stomach,liver,kidney,femoral head and spinal cord.The control group(23cases)was treated with chemotherapy alone:gemcitabine 1000 mg/m~2,intravenous infusion for 1,8,repeated every 3 weeks for a total of 4 cycles.The effective rate and acute adverse reaction of patients who received diffierent treatment options was measured and compared between the two groups during the course of radiotherapy and chemotherapy.The primary endpoint was disease progression or death,and progression-free survival(PFS)and overall survival(OS)were analyzed between the two groups.Results:The acute adverse reactions between two groups were mainly gastrointestinal reactions and myelosuppression.Most of grade 1/2 toxicity and grade 3/4 toxicity reaction between two groups had no statistical difference.Only Grade 1/2 platelet decline rate and grade 1/2 diarrhea in two groups were statistically different.Platelet decline rate was respectively 38.10% and 8.70%(P=0.020),and diarrhea rate was(19.05% vs 0%,P=0.021)respectively.The complete remission rate of the experimental group and the control group were 14.29% and 0%respectively.The total remission rate indicated in experimental group and control group were 38.10%and8.70%.Meanwhile,the effective rate between two groups were 76.19%and34.78%.No significant difference were indicated in the complete response rate between the two groups(P=0.06>0.05).However,there was statistical difference in total response rate and effective rate between the two groups(P=0.020,P=0.006).The progression-free survival time was 13.0 months(3.9-22.1 months)in the radiotherapy group,while 7.0 months(1.5-12.5 months)in the control group,statistical difference has been analysed(X~2=5.348,P<0.05).Meanwhile a significant difference was observed between the two groups(X~2=3.989,P<0.05),with median overall survival time of the radiotherapy group was 18.0 months(15.7-20.3 months)and control group was 14.0 months(6.5-21.5months).Conclusions:The study showed that for patients with advanced chemotherapy-resistant recurrent epithelial ovarian cancer,whole abdominal intensity-modulated radiotherapy increased 1/2 grade toxicity to a certain extent,but most patients were able to complete the entire treatment plan and achieved considerable efficacy.For progression-free survival and overall survival,the radiotherapy group also showed an advantage over chemotherapy.Whole abdominal intensity-modulated radiotherapy is expected to provide a new treatment concept for patients with staged ?/? chemotherapy-resistant recurrent epithelial ovarian cancer by increasing local control rate,platinum progression free interval(PFI)and overall survival.