Chapter-34 Radiotherapy in Ovarian Cancer—Current Concepts

BOOK TITLE: Ovarian Cancer: Comprehensive and Contemporary Management

1. Mahantshetty Umesh
2. Chadha Pranav
3. Engineer Reena
4. Shrivastava Shyam Kishore
Publishing Year
Author Affiliations
1. Tata Memorial Hospital, Mumbai, drumeshm@gmail.com, Tata Memorial Hospital, Mumbai, India, Tata Memorial Hospital, Dr Ernest Borges Marg, Parel, Mumbai, Maharashtra, India, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
2. Tata Memorial Hospital, Mumbai, radpranav@yahoo.com
3. Tata Memorial Hospital, Mumbai, reena_engineer@rediffmail.com, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
4. Tata Memorial Hospital, Mumbai, radonco@vsnl.net, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
Chapter keywords


Radiation therapy as a locoregional treatment has been explored in the past as salvage or consolidative treatment. However it took a back seat due to usage of non sophisticated techniques resulting in high incidence of toxicities. With technological advances and newer radiation techniques, there is a new and emerging enthusiasm in studying the role of radiotherapy in epithelial ovarian cancer. Whole abdominal radiation (WART) is recommended for a select subset of patients defined by stage, grade and histology. A Princess Margaret Hospital randomized trial shows survival benefit for WART in patients with macroscopic residual disease of less than 2 cm. Limitations of conventional WART are the dose limitation due to the proximity of kidneys to the peritoneal cavity, Grade III hematological toxicity, and delayed intestinal side effect. The newer radiotherapy modalities like 3D conformal radiation, Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT) reduce the toxicity by sparing of normal tissues. Further advances in radiation techniques like Adaptive Radiotherapy (ART), Respiratory Gaited Radiotherapy and use of Charged/Heavy particle therapy are in the research pipeline.

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