Safety and efficacy of new techniques of radiotherapy in oligometastatic recurrent ovarian cancer patients with BRCA1/2 mutation

Purpose of investigation: To evaluate the effectiveness and safety of radiotherapy (RT) for patients with recurrent ovarian cancer (ROC). Materials and Methods: Twenty-one patients with localized ovarian cancer relapses were treated with simultaneous-integrated boost intensity-modulated radiation therapy and stereotactic body radiation therapy/volumetric modulated arc therapy. BRCA 1/2 mutation was present in 13 patients (62%). Radiation therapy was directed to pelvic and nodal recurrences. Results: The median time to progression after successive lines gradually decreased. Six months after RT all patients had a complete response assessed by 18F-FDG PET/CT and CT scan; the overall response rate was 100%, including 21 complete remissions. Median progression-free survival (PFS) was 13 (range, 4-36) months for all patients; specifically, for patients with BRCA1/2 mutation was 13 (range, 11-19) months and for wild type patients it was six (range, 4-36) months. Patients who had a BRCA1/2 mutation showed significantly longer PFS than those who had not the mutation (median, 13 vs. 6 months) (p < 0.05). Acute and late gastrointestinal and genitourinary toxicity occurred in seven (33%) patients. Conclusions: Due to the effect on delay of successive treatments with radiation therapy, there will be a risk to chronicize ovarian disease. RT should be considered an alternative to secondary surgery in well-selected patients.

BRCA mutation; Radiation therapy; Recurrent ovarian cancer; Progression-free survival

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