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The use of high-dose radiation therapy, delivered to the abdominal area, may help relieve pain for women who have ovarian cancer that recurs after treatment and no longer responds to the standard platinum-based chemotherapy regimens. Pittsburgh researchers recently reported that such therapy may alleviate pain and other symptoms as well as enhance the quality of life for many women with this disease.

Cancer of the ovary is characterized by the presence of cancer cells in the ovary. There are 2 ovaries, located on either side of the uterus, or womb. Most ovarian cancers are of the lining, or epithelium, of the ovary. Treatment depends on the stage of disease (extent of disease at diagnosis), but commonly involves surgery to remove the ovaries, uterus, fallopian tubes, as much as the cancer as possible, and sometimes the fatty tissue of the abdomen and/or nearby lymph nodes. Following the surgery, many women also receive a standard chemotherapy combination of paclitaxel and a platinum-based compound to help prevent a recurrence (return) of the cancer and prolong survival. Despite this treatment approach, some women will still experience a recurrence of the cancer at some point. Those who experience a recurrence within 6 months of treatment are considered to have platinum-resistant cancer. For patients who have advanced ovarian cancer that recurs and is platinum resistant, additional treatments are needed to control the cancer, relieve the symptoms of disease, and prolong survival time. Recent studies have suggested that the chemotherapy drugs topotecan and liposomal doxorubicin can be effective against platinum-resistant disease; however, other options, such as radiation therapy, are also being studied.

Researchers in Pittsburgh recently treated 16 women who had recurrent, platinum-resistant ovarian cancer. All patients received high-dose (or high-fraction) radiation therapy, which was delivered once or twice per day, to the entire abdominal area. This regimen was relatively convenient for the patients, and the high doses allowed more cancer cells to be destroyed. All women experienced relief from their symptoms, including 5 who had complete pain relief and 7 who had partial pain relief. Thirty-one percent also had a shrinkage of the cancer, and most patients reported an improvement in their quality of life. The average duration of the response to treatment was 22 weeks, and the average survival time was 3 months. The main side effects of the treatment were nausea and vomiting, which lasted for 1 to 2 days.

These findings indicate that short courses of high-dose radiation therapy to the entire abdominal area may help relieve pain and other symptoms and improve quality of life for women with recurrent platinum-resistant ovarian cancer. Persons who have this type of disease may wish to talk with their doctor about the risks and benefits of participating in a clinical trial (research study) in which a promising new chemotherapy/radiation therapy regimen is being studied. (International Journal of Radiation Oncology and Biologic Physics, Vol 47, No 3, pp 749-754, 2000)

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