A Systematic Review of Maintenance Radiotherapy for Epithelial Ovarian Cancer_Chinese Journal of Evidence-Based Medicine

Authors：

MEI Ling , WEI Dongmei ,  FANG Fang

West China Second Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

FANG Fang, Email: fangf59@yahoo.com.cn

Keywords：

Epithelial ovarian cancer; Maintenance therapy; Maintenance-radiotherapy; Systematic review; Meta- analysis

DOI：

10.7507/1672-2531.20100483

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Objective 　To assess the efficacy and toxicity of the maintenance radiotherapy for epithelial ovarian cancer.
Methods 　We searched MEDLINE (1950 to 2009), EMbase (1966 to 2009), The Cochrane Library (Issue 1, 2009), CBMdisc (1978 to 2009), CNKI (1979 to 2009), VIP (1989 to 2009) and relevant internet websites to identify randomized controlled trials (RCTs) of maintenance radiotherapy for epithelial ovarian cancer. The quality of the included trials was assessed by Cochrane Systematic Review Handbook. Meta-analyses were conducted by RevMan 5.0 and SPSS 10.0 software.
Results 　A total of 5 RCTs involving 529 patients were identified. The result of meta-analyses showed that the whole-abdominal radiation increased the 5-year progression-free survival (PFS) at RR1.76 and 95%CI 1.13 to 2.73, while it showed no effect on the 5-year overall survival (OS) at RR1.30 and 95%CI 0.96 to 1.76. The main adverse reactions of maintenance radiotherapy for epithelial ovarian cancer included diarrhea and abdominal pains, whose severity was related to radiation dose.
Conclusion 　The whole-abdominal radiation can increase the 5-year PFS while its effect on the 5-year OS needs to be further studied.

Citation： MEI Ling,WEI Dongmei,FANG Fang. A Systematic Review of Maintenance Radiotherapy for Epithelial Ovarian Cancer. Chinese Journal of Evidence-Based Medicine, 2010, 10(6): 724-729. doi: 10.7507/1672-2531.20100483 Copy

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4.	Hakes TB, Chalas E, Hoskins WJ, et al. Randomized prospective trial of 5 versus 10 cycles of cyclopphosphamide doxorubincin,and cisplatin in advanced ovarian carcinoma. Gynecologic Oncology, 1992, 45(3): 284-288.
5.	Lambert HE, Rustin GJS, Gregory WM, et al. A randomized trial of five versus eight courses of cisplatin or carboplatin in advanced epithelial ovarian carcinoma: A North Thames Ovary Group Study. Annals of Oncology, 1997, 8(4): 327-333.
6.	Ozols RF.Maintenance chemotherapy standard care——No! ASCO 2004.
7.	Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5. The Cochrane Collaboration, 2006. 91-95.
8.	Sorbe B. 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. Int J Gyne Canc, 2003, 13(3): 278-286.
9.	Pickel H, Lahousen M, Petru E, et al. Consolidation Radiotherapy after Carboplatin-Based Chemotherapy in Radically Operated Advanced Ovarian Cancer. Gyne Oncol, 1999, 72(2): 215-219.
10.	Varia MA, Stehman FB, Bundy BN, et al. Intraperitoneal Radioactive Phosphorus (32P) Versus Observation After Negative Second-Look Laparotomy for Stage III Ovarian Carcinoma: A Randomized Trial of the Gynecologic Oncology Group. J Clin Oncol, 2003, 21(15): 2849-2855.
11.	Vergote IB, Winderen M, De Vos LN, et al. Intraperitoneal Radioactive Phosphorus Therapy in Ovarian Carcinoma Analysis of 313 patients treated primarily or at second-look laparotomy. Cancer, 1993, 71(7): 2250-2260.
12.	Bruzzone M, Repetto L, Chiara S, et al. Chemotherapy versus Radiotherapy in the Management of Ovarian Cancer Patients with Pathological Complete Response or Minimal Residual Disease at Second Look. Gyne Oncol, 1990, 38(3): 392-395.
13.	Lambert HE, Rustin GJS, Gregory WM, et al. Arandomized Trial Comparing Single-Agent Carboplatin With Carboplatin Followed by Radiotherapy for Advanced Ovarian Cancer: A North Thames Ovarian Group Study. J Clin Oncol, 1993, 11(3): 440-448.
14.	Lawton F, Luesley D, Blackledge G, et al. A randomized trial comparing whole abdominal radiotherapy with chemotherapy following cisplatinum cytoreduction in epithelial ovarian cancer. West Midlands Ovarian Cancer Group Trial II. Clinical Oncology, 1990, 2(1): 4-9.

1. Berek JS, Hacker NF, eds. Practical Gynecologic Oncology. 3rd ed. Lippincott Williams & Wilkins, 2000. 204.
2. Berek JS 主编. 段涛, 丰有吉译. Novak’s Gynecology. 第13版. 人民卫生出版社, 2005: 869.
3. Bertelsen K, Jakobsen A, Stroyer I, et al. A prospective Randomized Comparison of 6 and 12 Cycles of cyclophosphamide, Adriamycin, and Cisplatin in Advanced Epithelial Ovarian Cancer: A Danish Ovarian Study Group Trial(DACOVA). Gynecologic Oncology, 1993, 49(1): 30-36.
4. Hakes TB, Chalas E, Hoskins WJ, et al. Randomized prospective trial of 5 versus 10 cycles of cyclopphosphamide doxorubincin,and cisplatin in advanced ovarian carcinoma. Gynecologic Oncology, 1992, 45(3): 284-288.
5. Lambert HE, Rustin GJS, Gregory WM, et al. A randomized trial of five versus eight courses of cisplatin or carboplatin in advanced epithelial ovarian carcinoma: A North Thames Ovary Group Study. Annals of Oncology, 1997, 8(4): 327-333.
6. Ozols RF.Maintenance chemotherapy standard care——No! ASCO 2004.
7. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5. The Cochrane Collaboration, 2006. 91-95.
8. Sorbe B. 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. Int J Gyne Canc, 2003, 13(3): 278-286.
9. Pickel H, Lahousen M, Petru E, et al. Consolidation Radiotherapy after Carboplatin-Based Chemotherapy in Radically Operated Advanced Ovarian Cancer. Gyne Oncol, 1999, 72(2): 215-219.
10. Varia MA, Stehman FB, Bundy BN, et al. Intraperitoneal Radioactive Phosphorus (32P) Versus Observation After Negative Second-Look Laparotomy for Stage III Ovarian Carcinoma: A Randomized Trial of the Gynecologic Oncology Group. J Clin Oncol, 2003, 21(15): 2849-2855.
11. Vergote IB, Winderen M, De Vos LN, et al. Intraperitoneal Radioactive Phosphorus Therapy in Ovarian Carcinoma Analysis of 313 patients treated primarily or at second-look laparotomy. Cancer, 1993, 71(7): 2250-2260.
12. Bruzzone M, Repetto L, Chiara S, et al. Chemotherapy versus Radiotherapy in the Management of Ovarian Cancer Patients with Pathological Complete Response or Minimal Residual Disease at Second Look. Gyne Oncol, 1990, 38(3): 392-395.
13. Lambert HE, Rustin GJS, Gregory WM, et al. Arandomized Trial Comparing Single-Agent Carboplatin With Carboplatin Followed by Radiotherapy for Advanced Ovarian Cancer: A North Thames Ovarian Group Study. J Clin Oncol, 1993, 11(3): 440-448.
14. Lawton F, Luesley D, Blackledge G, et al. A randomized trial comparing whole abdominal radiotherapy with chemotherapy following cisplatinum cytoreduction in epithelial ovarian cancer. West Midlands Ovarian Cancer Group Trial II. Clinical Oncology, 1990, 2(1): 4-9.

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A Systematic Review of Maintenance Radiotherapy for Epithelial Ovarian Cancer

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