Treatment of stage I and II ovarian cancer (interim report of intraperitoneal chemotherapeutic perfusion and postoperative prophylactic intracavitary irradiation)

• Published in: Nihon Sanka Fujinka Gakkai zasshi Vol. 37; no. 1; p. 38
• Main Authors: Hirabayashi, K, Okada, E, Numoto, A, Nakazuma, Y
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.01.1985
• Subjects: Brachytherapy - methods; Combined Modality Therapy; Female; Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - radiotherapy; Ovarian Neoplasms - surgery; Ovarian Neoplasms - therapy; Postoperative Period; Radiotherapy Dosage; Uterine Neoplasms - prevention & control; Uterine Neoplasms - radiotherapy
• ISSN: 0300-9165

74 cases of primary ovarian cancer treated here previously were classified into three groups, no residual (corresponding to Stage Ia, Ib), cell residual (Ic-IIc) and mass residual (III, IV), and prognoses were compared. The 5 year survival rates were 83.3%, 29.4% and 12.6% respectively. In Stage I and II cases, almost all of the tumor mass would be removed by operation. Therefore the target of postoperative treatment should be the residual cancer as cell units spread widely throughout the abdominal cavity. For this purpose, IPCP has been performed on 35 cases of Stage I and II since 1977. The 3 year survival rate for this series is as good as 88.6%, and the sites of recurrence were localized in the small pelvic cavity adjacent to the Douglas pouch in 5 out of 6 relapsed cases. This fact suggests that IPCP is capable of controlling the cancer cells in the upper abdominal cavity, but still insufficient to control them in the pelvic cavity where deeper invasion is suspected. In order to improve the local control ability, utilization of the uterus as the applicator for prophylactic intracavitary irradiation came to be considered. The spread of cancer to the uterus was found in 5 out of 38 cases in Stage I and II(13.2%), but silent invasion was found in only one case. These results suggests that the utilization of the uterus as the applicator for prophylactic intracavitary irradiation would be feasible if no macroscopical cancer extention to the uterus exists and the uterus is suitable for application. Several combinations with Tandem and Ovoid have been tested and an adequate method has been proposed.