[Postoperative radiotherapy of epithelial ovarian cancers]

The importance of postoperative radiotherapy in patients with epithelial ovarian carcinomas was examined critically by means of our own results and the experiences published in international literature. 220 (36.2%) patients out of 608, whose inner genital tract could at least be partially removed, survived after irradiation therapy only without any chemotherapy. In FIGO stages I to III, without consideration of residual tumour mass, a survival rate of 73% after one year, 56% after two years, 47% after three years, 42% after four years and of 40% after five years after only postoperative irradiation therapy has been attained in the course of the last few years. To arrive at a useful comparison, several prognostic factors have to be considered in the estimation of therapeutic results of ovarian cancer. These prognostic factors are the non-resectable residual tumour mass, histology (cell type and grading), age of the patient and tumour stage (diagnosis, surgical technique, completeness of operation). Although our abdominal pelvic irradiation technique with 60-cobalt merely seems to be a compromise, we attained a remission rate and cure rate comparable to the results after postoperative chemotherapy. Our abdominal pelvic irradiation technique was well tolerated. The most frequent complication was an ileus (5.6%), whereas fistulas developed in 1.6% of all cases. According to the results of former randomised studies, postoperative irradiation is effective only in patients with residual tumour mass smaller than 2 cm, if an adequate irradiation technique could be performed. Hence, prospective chemotherapeutic studies should include a therapeutic arm with irradiation therapy alone or in combination with chemotherapy to clarify the importance of postoperative irradiation therapy in ovarian carcinomas.