Radiation Therapy for Recurrent Clear-Cell Cancer of the Ovary
| Autor: | Katherine Fuh, Lee-may Chen, Jennifer Leah McNally, I-Chow Hsu, Daniel S. Kapp, Gina L. Westhoff, Nelson N.H. Teng, Terry A. Longacre |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Oncology medicine.medical_specialty medicine.medical_treatment Gastroenterology California 03 medical and health sciences 0302 clinical medicine Internal medicine Carcinoma medicine Humans 030212 general & internal medicine Stage (cooking) Aged Retrospective Studies Ovarian Neoplasms Proportional hazards model business.industry Hazard ratio Obstetrics and Gynecology Cancer Retrospective cohort study Middle Aged medicine.disease Confidence interval Radiation therapy 030220 oncology & carcinogenesis Female Neoplasm Recurrence Local business Adenocarcinoma Clear Cell |
| Zdroj: | International Journal of Gynecologic Cancer. 26:1608-1614 |
| ISSN: | 1525-1438 1048-891X |
| DOI: | 10.1097/igc.0000000000000810 |
| Popis: | ObjectiveGiven the relative chemo-resistant nature of clear-cell gynecologic cancers, we investigated the utility of radiation therapy (RT) to treat recurrent clear-cell carcinoma (CCC) of the ovary.MethodsA retrospective chart review of patients with recurrent CCC managed from 1994–2012 was conducted at 2 academic medical centers. Demographic and clinicopathologic factors were abstracted and evaluated using Pearson χ2 or t tests, Kaplan-Meier and Cox regression analyses.ResultsFifty-three patients had recurrent CCC, and 24 (45.3%) of these patients received RT. There were no significant differences in age, stage, optimal cytoreduction, platinum response, or the percentage of patients that received more than 3 regimens of chemotherapy between the 2 groups. Patients who received RT for recurrent CCC were more likely to have had a focal recurrence (62.5% vs 10.3%, P ≤ 0.001) and to have undergone secondary cytoreduction (70.8% vs 10.3%, P ≤ 0.001). Of patients who received RT, 73.9% underwent surgery with or before their treatment. Five-year survival after recurrence was significantly higher in the group that received RT, 62.9% versus 18.8% (P = 0.002). In a multivariate analysis, platinum-sensitive disease and RT were associated with improved survival from recurrence, (hazard ratio, 0.26; 95% confidence interval, 0.08-0.81; P = 0.02 and hazard ratio, 0.28; 95% confidence interval, 0.09–0.90, P = 0.03, respectively).ConclusionsIn this cohort of patients with recurrent CCC, platinum-sensitive disease and RT are associated with improved survival. However, it is important to note that the majority of these patients underwent surgery along with RT, and it may be that the benefit of RT is limited to those who undergo secondary cytoreduction. |
| Databáze: | OpenAIRE |
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