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Consolidation treatment of advanced (FIGO stage III) ovarian carcinoma in complete surgical remission after induction chemotherapy: A randomized, controlled, clinical trial comparing whole abdominal radiotherapy, chemotherapy, and no further treatment

Authors


  • Swedish-Norwegian Ovarian Cancer Study Group: C Tropé, R. Nordal, the Norwegian Radium Hospital, Oslo; A. Himmelmann, K. Kjörstad, Department of Gynecology and Obstetrics, University Hospital, Tromsö; M. Onsrud, Department of Gynecology and Obstetrics, University Hospital, Trondheim, Norway; E. Simonsen, T. Högberg, Department of Gynecologic Oncology, University Hospital, Linköping; N. Einhorn, F. Pettersson, B. Frankendal, Radiumhemmet, Karolinska Hospital, Stockholm; B. Pettersson, B. Tholander, Department of Gynecologic Oncology, University Hospital, Uppsala; L. Svanberg, Department of Gynecology and Obstetrics, University Hospital, Malmö, Sweden.

Address correspondence and reprint requests to: B. Sorbe, MD, PhD, Department of Gynecological Oncology, Örebro University Hospital, SE-701 85, Örebro, Sweden. Email: bengt.sorbe@ orebroll.se.

Abstract.

In a prospective randomized trial, consolidation treatment with radiotherapy or chemotherapy was compared with no treatment in a series of 172 patients with epithelial ovarian carcinoma, FIGO stage III, with complete surgical remission after primary cytoreductive surgery and induction chemotherapy. In the subgroup with complete surgical and pathologic remission, progression-free survival was significantly (P = 0.032) better in the radiotherapy group (56% at 5 years) than in the chemotherapy group (36% at 5 years) and the untreated control group (35% at 5 years). Overall survival was also most favorable in the radiotherapy group (69% at 5 years). The number of recurrences was lowest in the radiotherapy group. In the subgroup with microscopic residual carcinoma there were no significant differences in survival between the radiotherapy and the chemotherapy-treated patients. Early and late radiation reactions were recorded. Treatment-related side effects were seen most frequently in the radiotherapy group. Late intestinal radiation reactions of a severe type were recorded in 10%.

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