PMID- 33665491
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240331
IS  - 2452-1094 (Print)
IS  - 2452-1094 (Electronic)
IS  - 2452-1094 (Linking)
VI  - 6
IP  - 1
DP  - 2021 Jan-Feb
TI  - Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial 
      Ovarian Cancer: Efficacy in the Era of Modern Technology and Targeted Agents.
PG  - 100624
LID - 10.1016/j.adro.2020.11.009 [doi]
LID - 100624
AB  - 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.
CI  - (c) 2020 The Author(s).
FAU - Butala, Anish A
AU  - Butala AA
AD  - Department of Radiation Oncology, Perelman School of Medicine at the University 
      of Pennsylvania, Philadelphia, Pennsylvania.
FAU - Patel, Roshal R
AU  - Patel RR
AD  - Albany Medical College, Albany, New York.
FAU - Manjunath, Shwetha
AU  - Manjunath S
AD  - Department of Radiation Oncology, Perelman School of Medicine at the University 
      of Pennsylvania, Philadelphia, Pennsylvania.
FAU - Latif, Nawar A
AU  - Latif NA
AD  - Department of Gynecologic Oncology, Perelman School of Medicine at the University 
      of Pennsylvania, Philadelphia, Pennsylvania.
FAU - Haggerty, Ashley F
AU  - Haggerty AF
AD  - Department of Gynecologic Oncology, Perelman School of Medicine at the University 
      of Pennsylvania, Philadelphia, Pennsylvania.
FAU - Jones, Joshua A
AU  - Jones JA
AD  - Department of Radiation Oncology, Perelman School of Medicine at the University 
      of Pennsylvania, Philadelphia, Pennsylvania.
FAU - Taunk, Neil K
AU  - Taunk NK
AD  - Department of Radiation Oncology, Perelman School of Medicine at the University 
      of Pennsylvania, Philadelphia, Pennsylvania.
LA  - eng
PT  - Journal Article
DEP - 20201125
PL  - United States
TA  - Adv Radiat Oncol
JT  - Advances in radiation oncology
JID - 101677247
PMC - PMC7897761
EDAT- 2021/03/06 06:00
MHDA- 2021/03/06 06:01
PMCR- 2020/11/25
CRDT- 2021/03/05 06:08
PHST- 2020/04/08 00:00 [received]
PHST- 2020/08/10 00:00 [revised]
PHST- 2020/11/11 00:00 [accepted]
PHST- 2021/03/05 06:08 [entrez]
PHST- 2021/03/06 06:00 [pubmed]
PHST- 2021/03/06 06:01 [medline]
PHST- 2020/11/25 00:00 [pmc-release]
AID - S2452-1094(20)30354-7 [pii]
AID - 100624 [pii]
AID - 10.1016/j.adro.2020.11.009 [doi]
PST - epublish
SO  - Adv Radiat Oncol. 2020 Nov 25;6(1):100624. doi: 10.1016/j.adro.2020.11.009. 
      eCollection 2021 Jan-Feb.