Cargando…
Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents
PURPOSE: Metastatic, persistent, or recurrent epithelial ovarian cancer (MPR-EOC) remains a significant threat to patient mortality despite advances in novel targeted agents. Radiation therapy (RT) is often used as a palliative option. We report outcomes of a large series of MPR-EOC patients treated...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897761/ https://www.ncbi.nlm.nih.gov/pubmed/33665491 http://dx.doi.org/10.1016/j.adro.2020.11.009 |
_version_ | 1783653732376903680 |
---|---|
author | Butala, Anish A. Patel, Roshal R. Manjunath, Shwetha Latif, Nawar A. Haggerty, Ashley F. Jones, Joshua A. Taunk, Neil K. |
author_facet | Butala, Anish A. Patel, Roshal R. Manjunath, Shwetha Latif, Nawar A. Haggerty, Ashley F. Jones, Joshua A. Taunk, Neil K. |
author_sort | Butala, Anish A. |
collection | PubMed |
description | PURPOSE: Metastatic, persistent, or recurrent epithelial ovarian cancer (MPR-EOC) remains a significant threat to patient mortality despite advances in novel targeted agents. Radiation therapy (RT) is often used as a palliative option. We report outcomes of a large series of MPR-EOC patients treated with modern palliative RT (PRT) in an era of novel systemic therapies. METHODS AND MATERIALS: A retrospective review was conducted of women treated with PRT for MPR-EOC between 2007 and 2019 at an academic institution. Clinical response rates were recorded at <1 month, 1 to 3 months, and >3 months. Radiographic responses were categorized by RECIST 1.1 criteria. Overall response rate (ORR) was the sum of complete and partial response. Linear regression analyses of baseline characteristics were conducted for statistical testing. RESULTS: Eighty-six patients with PMR-OC received 120 courses of palliative RT. Median follow-up was 8.6 months. Median age was 61 (range, 22-82). Thirty-six percent of women received central nervous system (CNS)-directed RT. In addition, 43% received targeted therapies before RT. Clinical ORR within 1 month and at last follow-up for non-CNS lesions was 79% and 61% (69% and 88% for CNS lesions, respectively). High-grade serous lesions were more likely to have clinical response (P = .04). Biologically effective doses (BED) >39 Gy were associated with improved clinical response in CNS lesions (P = .049). Bony sites were associated with worse clinical (P = .004) response in non-CNS lesions compared with soft tissue or nodal sites. Acute or late grade 3+ toxicities with bevacizumab were low (8.7%/4.3%). CONCLUSIONS: PRT offers excellent rates of response for symptomatic patients with MPR-EOC within 1 month of treatment, with durable responses beyond 3 months. High-grade serous lesions were associated with improved response in all patients. Higher BED and soft tissue or nodal sites were associated with improved response in CNS and non-CNS patients, respectively. Acute or late toxicities with bevacizumab and PRT were low. Prospective investigation is warranted to determine the optimal PRT regimen. |
format | Online Article Text |
id | pubmed-7897761 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-78977612021-03-03 Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents Butala, Anish A. Patel, Roshal R. Manjunath, Shwetha Latif, Nawar A. Haggerty, Ashley F. Jones, Joshua A. Taunk, Neil K. Adv Radiat Oncol Scientific Article PURPOSE: Metastatic, persistent, or recurrent epithelial ovarian cancer (MPR-EOC) remains a significant threat to patient mortality despite advances in novel targeted agents. Radiation therapy (RT) is often used as a palliative option. We report outcomes of a large series of MPR-EOC patients treated with modern palliative RT (PRT) in an era of novel systemic therapies. METHODS AND MATERIALS: A retrospective review was conducted of women treated with PRT for MPR-EOC between 2007 and 2019 at an academic institution. Clinical response rates were recorded at <1 month, 1 to 3 months, and >3 months. Radiographic responses were categorized by RECIST 1.1 criteria. Overall response rate (ORR) was the sum of complete and partial response. Linear regression analyses of baseline characteristics were conducted for statistical testing. RESULTS: Eighty-six patients with PMR-OC received 120 courses of palliative RT. Median follow-up was 8.6 months. Median age was 61 (range, 22-82). Thirty-six percent of women received central nervous system (CNS)-directed RT. In addition, 43% received targeted therapies before RT. Clinical ORR within 1 month and at last follow-up for non-CNS lesions was 79% and 61% (69% and 88% for CNS lesions, respectively). High-grade serous lesions were more likely to have clinical response (P = .04). Biologically effective doses (BED) >39 Gy were associated with improved clinical response in CNS lesions (P = .049). Bony sites were associated with worse clinical (P = .004) response in non-CNS lesions compared with soft tissue or nodal sites. Acute or late grade 3+ toxicities with bevacizumab were low (8.7%/4.3%). CONCLUSIONS: PRT offers excellent rates of response for symptomatic patients with MPR-EOC within 1 month of treatment, with durable responses beyond 3 months. High-grade serous lesions were associated with improved response in all patients. Higher BED and soft tissue or nodal sites were associated with improved response in CNS and non-CNS patients, respectively. Acute or late toxicities with bevacizumab and PRT were low. Prospective investigation is warranted to determine the optimal PRT regimen. Elsevier 2020-11-25 /pmc/articles/PMC7897761/ /pubmed/33665491 http://dx.doi.org/10.1016/j.adro.2020.11.009 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Scientific Article Butala, Anish A. Patel, Roshal R. Manjunath, Shwetha Latif, Nawar A. Haggerty, Ashley F. Jones, Joshua A. Taunk, Neil K. Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents |
title | Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents |
title_full | Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents |
title_fullStr | Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents |
title_full_unstemmed | Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents |
title_short | Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents |
title_sort | palliative radiation therapy for metastatic, persistent, or recurrent epithelial ovarian cancer: efficacy in the era of modern technology and targeted agents |
topic | Scientific Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897761/ https://www.ncbi.nlm.nih.gov/pubmed/33665491 http://dx.doi.org/10.1016/j.adro.2020.11.009 |
work_keys_str_mv | AT butalaanisha palliativeradiationtherapyformetastaticpersistentorrecurrentepithelialovariancancerefficacyintheeraofmoderntechnologyandtargetedagents AT patelroshalr palliativeradiationtherapyformetastaticpersistentorrecurrentepithelialovariancancerefficacyintheeraofmoderntechnologyandtargetedagents AT manjunathshwetha palliativeradiationtherapyformetastaticpersistentorrecurrentepithelialovariancancerefficacyintheeraofmoderntechnologyandtargetedagents AT latifnawara palliativeradiationtherapyformetastaticpersistentorrecurrentepithelialovariancancerefficacyintheeraofmoderntechnologyandtargetedagents AT haggertyashleyf palliativeradiationtherapyformetastaticpersistentorrecurrentepithelialovariancancerefficacyintheeraofmoderntechnologyandtargetedagents AT jonesjoshuaa palliativeradiationtherapyformetastaticpersistentorrecurrentepithelialovariancancerefficacyintheeraofmoderntechnologyandtargetedagents AT taunkneilk palliativeradiationtherapyformetastaticpersistentorrecurrentepithelialovariancancerefficacyintheeraofmoderntechnologyandtargetedagents |