Radiotherapy for Ovarian Cancers - Redefining the Role

  • Rai, Bhavana (Department of Radiotherapy and Oncology and Regional Cancer Centre, Postgraduate Institute of Medical Education and Research) ;
  • Bansal, Anshuma (Department of Radiotherapy and Oncology and Regional Cancer Centre, Postgraduate Institute of Medical Education and Research) ;
  • Patel, Firuza Darius (Department of Radiotherapy and Oncology and Regional Cancer Centre, Postgraduate Institute of Medical Education and Research) ;
  • Sharma, Suresh Chander (Department of Radiotherapy and Oncology and Regional Cancer Centre, Postgraduate Institute of Medical Education and Research)
  • Published : 2014.06.30


Radiation therapy in ovarian cancers has been considered an outdated concept for many years, mainly due to its toxicity and failure to show benefit in terms of survival. Chemotherapy has been extensively used after surgery for these cancers and it has almost replaced radiation therapy as an adjuvant treatment. Nevertheless, failures in ovarian cancers continue to occur even with the use of newer and effective chemotherapy regimens. About 70% patients demonstrate recurrence in the abdomen or pelvis after first line chemotherapy in ovarian cancers. With advances in technology and sophistication of radiation techniques, along with the molecular and biological knowledge of distinct histological subtypes, there is a need to redefine the role of radiation therapy. This review article focuses on the literature on use of radiation in ovarian cancers and its rationale and indications in the present day. For this, a literature pub med/medline search was performed from January 1975 to March 2014 to redefine the role of radiotherapy in ovarian cancers.


  1. Bhurgri Y, Shaheen Y, Kayani N, et al (2011). Incidence, trends and morphology of ovarian cancer in Karachi (1995-2002). Asian Pac J Cancer Prev, 12, 1567-71.
  2. Biete A, Valduvieco I, Rovirosa A, et al (2010). Whole abdominal radiotherapy in ovarian cancer. Rep Pract Oncol Radiother, 15, 27-30.
  3. Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ (2002). Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol, 20, 1248-59.
  4. Brown AP, Jhingran A, Klopp AH, et al(2013). Involved-field radiation therapy for locoregionally recurrent ovarian cancer. Gynecol Oncol, 130, 300-5.
  5. Chang JS, Koom WS, Kim SW, et al(2013). Risk stratification of abdominopelvic failure for FIGO stage III epithelial ovarian cancer patients: implications for adjuvant radiotherapy. J Gynecol Oncol, 24, 146-53.
  6. Corn BW, Lanciano RM, Boente M, et al (1994). Recurrent ovarian cancer. Effective radiotherapeutic palliation after chemotherapy failure. Cancer, 74, 2979-83.<2979::AID-CNCR2820741114>3.0.CO;2-B
  7. De Meerleer G, Vandecasteele K, Ost P, et al (2011). Whole abdominopelvic radiotherapy using intensity-modulated arc therapy in the palliative treatment of chemotherapyresistant ovarian cancer with bulky peritoneal disease: a single-institution experience. Int J Radiat Oncol Biol Phys, 79, 775-81.
  8. Dembo AJ (1992). Epithelial ovarian cancer: the role of radiotherapy. Int J Radiat Oncol Biol Phys, 22, 835-45.
  9. Dembo AJ, Bush RS (1982). Choice of postoperative therapy based on prognostic factors. Int J Radiat Oncol Biol Phys, 8, 893-7.
  10. Dembo AJ, Bush RS, Beale FA, et al (1979). Improved survival following abdominopelvic irradiation in patients with a completed pelvic operation. Am J Obstet Gynecol, 134, 793-800.
  11. Eltabbakh GH, Goodrich S (2006). Update on the treatment of recurrent ovarian cancer. Womens Health (Lond Engl), 2, 127-39.
  12. Gocheva L (2003). Whole abdomen irradiation in epithelial ovarian cancer - state of the art. Wspotczesna Onkologia, 13, 181-90.
  13. Hoskins PJ, Le N, Gilks B, et al (2012). Low-stage ovarian clear cell carcinoma: population-based outcomes in British Columbia, Canada, with evidence for a survival benefit as a result of irradiation. J Clin Oncol, 30, 1656-62.
  14. Kobel M, Kalloger SE, Huntsman DG, et al (2010). Differences in tumor type in low-stage versus high-stage ovarian carcinomas. Int J Gynecol Pathol, 29, 203-11.
  15. Kojs Z, Glinski B, Reinfuss M, et al (2001). Results of a randomized prospective trial comparing postoperative abdominopelvic radiotherapy with postoperative chemotherapy in early ovarian cancer. Cancer Radiother, 5, 5-11.
  16. Mahantshetty U, Jamema S, Engineer R, et al (2010). Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric are based intensity modulation. Radiat Oncol, 15, 106.
  17. Murthy NS, Shalini S, Suman G, Pruthvish S, Mathew A (2009). Changing trends in incidence of ovarian cancer - the Indian scenario. Asian Pac J Cancer Prev, 10, 1025-30.
  18. Nagai Y, Inamine M, Hirakawa M, et al (2007). Postoperative whole abdominal radiotherapy in clear cell adenocarcinoma of the ovary. Gynecol Oncol, 107, 469-73.
  19. Ozols RF (1997): Controversies in the management of ovarian cancer. Int J Gynecol Cancer, 7, 27-32.
  20. Quon M, Gallant V, Samant R (2006). Effective palliative radiotherapy for symptomatic recurrent or residual ovarian cancer. Gynecol Oncol, 102, 204-9.
  21. Rochet N, Kieser M, Sterzing F, et al (2011). Phase II study evaluating consolidation whole abdominal intensitymodulated radiotherapy (IMRT) in patients with advanced ovarian cancer stage FIGO III--the OVAR-IMRT-02 Study. BMC Cancer, 28, 11-41.
  22. Rochet N, Sterzing F, Jensen AD, et al (2010). Intensitymodulated whole abdominal radiotherapy after surgery and carboplatin/taxane chemotherapy for advanced ovarian cancer: phase I study. Int J Radiat Oncol Biol Phys, 76, 1382-9.
  23. Shetty UM, Shankar S, Engineer R, et al (2013). Image guided intensity modulated whole abdomen radiation therapy in relapsed epithelial ovarian cancers: a feasibility study. J Can Res Ther, 9, 17-21.
  24. Sirichaisutdhikorn D, Suprasert P, Khunamornpong S (2009). Clinical outcome of the ovarian clear cell carcinoma compared to other epithelial ovarian cancers when treated with paclitaxel and carboplatin. Asian Pac J Cancer Prev, 10, 1041-5.
  25. Sorbe B (2003). Consolidation treatment of advanced (FIGO stage III) ovarian carcinoma in complete surgical remission after induction chemotherapy: a randomized, controlled, clinical trial comparing whole abdominal radiotherapy, chemotherapy, and no further treatment. Int J Gynecol Cancer, 13, 276-8.
  26. Suprasert P, Manopunya M, Cheewakriangkrai C (2014). Outcomes with single agent LIPO-DOX in platinumresistant ovarian and fallopian tube cancers and primary peritoneal adenocarcinoma - Chiang Mai University Hospital Experience. Asian Pac J Cancer Prev, 15, 1145-8.
  27. Swenerton KD, Santos JL, Gilks CB, et al (2011). Histotype predicts the curative potential of radiotherapy: The example of ovarian cancers. Ann Oncol, 22, 341-7.
  28. Thomas G (2013). Revisiting the role of radiation treatment for non-serous subtypes of epithelial ovarian cancer. Am Soc Clin Oncol Educ Book, 31, e205.
  29. Yahara K, Ohguri T, Imada H, et al (2013). Epithelial ovarian cancer: definitive radiotherapy for limited recurrence after complete remission had been achieved with aggressive front-line therapy. J Radiat Res, 54, 322-9.

Cited by

  1. Evaluation of Effects of Metformin in Primary Ovarian Cancer Cells vol.16, pp.16, 2015,
  2. Prevalence of Anxiety May Not be Elevated in Thai Ovarian Cancer Patients Following Treatment vol.16, pp.3, 2015,
  3. XIAP Associated Factor 1 (XAF1) Represses Expression of X-linked Inhibitor of Apoptosis Protein (XIAP) and Regulates Invasion, Cell Cycle, Apoptosis, and Cisplatin Sensitivity of Ovarian Carcinoma Cells vol.16, pp.6, 2015,
  4. Prognostic values of 5-hmC, 5-mC and TET2 in epithelial ovarian cancer vol.292, pp.4, 2015,
  5. Fractionated Palliative Pelvic Radiotherapy as an Effective Modality in the Management of Recurrent/Refractory Epithelial Ovarian Cancers: An Institutional Experience vol.67, pp.2, 2017,
  6. Impact on survival with adjuvant radiotherapy for clear cell, mucinous, and endometriod ovarian cancer: the SEER experience from 2004 to 2011 vol.27, pp.5, 2016,