Is there still a place for radiotherapy in epithelial ovarian carcinoma? (La radiothe?rapie dans les cancers ovariens a-t-elle encore une place?)

摘要

Ovarian carcinomas naturally spread to the peritoneal cavity and despite optimal debulking surgery, more than 85% of relapses are located in the abdominal cavity. External irradiation can treat residual disease after surgery (microscopic disease). Nevertheless, the use of radiation therapy has decreased because of toxicity and the use of polychemotherapy with paclitaxel and platine. The techniques of whole abdominal irradiation are developed in this article. Acute and late toxicity and results in the case of adjuvant treatment or as consolidative treatment are reported with careful attention to the literature (randomized trials). Some mechanisms explaining bowel toxicity are better known now than they were before and new developments of external irradiation like tomotherapy and intensity-modulated radiation therapy focused on abdominal radiotherapy can allow new studies integrating radiotherapy in the treatment planning of ovarian carcinoma after initial surgery and polychemotherapy regimens, especially with cisplatinum and paclitaxel. New prospective studies or randomized trials are necessary to assess if radiotherapy still has a place in the management of ovarian carcinoma. Springer 2006.