Kosin Med J.  2023 Dec;38(4):293-299. 10.7180/kmj.23.146.

Selective adjuvant radiation therapy for distant lymph node metastasis in patients with stage 4B epithelial ovarian cancer: a case series

• Kim ET
• Oh SY
• Ma SY
• Lee TH
• Kim WG

• KMID: 2549503
• DOI: http://doi.org/10.7180/kmj.23.146

Abstract

Although the efficacy of surgery followed by taxane- and platinum-based systemic chemotherapy has been clearly demonstrated in the standard first-line treatment of epithelial ovarian cancer, the role of radiation therapy for distant lymph node metastasis in patients with epithelial ovarian cancer is not well-established due to a lack of reported studies. We identified four patients who underwent selective adjuvant radiation therapy for neck and para-aortic lymph node lesions after primary debulking surgery between 2020 and 2022, followed by platinum-based chemotherapy for stage 4B high-grade serous ovarian cancer. Through a retrospective review of medical records, we analyzed patient clinicopathologic features, treatment course, and imaging findings. The median age was 49.25 years (range, 46–54 years). All patients had the International Federation of Gynecology and Obstetrics stage 4B disease. Following primary debulking surgery, all patients received weekly paclitaxel-carboplatin chemotherapy and maintenance treatment with poly(ADP-ribose) polymerase (PARP) inhibitors. All patients received selective adjuvant radiation therapy for neck and para-aortic lymph node metastasis before PARP inhibitor maintenance. The median follow-up time was 36.75 months (range, 19–45 months). All patients achieved a complete response. None of the patients experienced disease recurrence or died during the follow-up period. The management of distant lymph node metastasis in patients with epithelial ovarian cancer remains a matter of debate. Selective adjuvant radiation therapy in first-line treatment for ovarian cancer appears to be a feasible approach with maintenance therapy for stage 4B epithelial ovarian cancer.

Keyword

Adjuvant radiotherapy; Case reports; Lymphatic metastasis; Ovarian neoplasms; Poly(ADP-ribose) polymerase inhibitors

Figure

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  Fig. 1. Positron emission tomography (PET) image of patient number 1 in Table 1. Two isolated high standardized uptake values (SUVs), in the left supraclavicular lymph node (A, C: maximum SUV 5.6) and aortocaval area (B, C: maximum SUV 6.6) in the PET image (red and black arrows).

Reference

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