The Role of Radiotherapy in Localized Recurrent Ovarian Cancer: A Retrospective Cohort Analysis and Review of the Literature

Background: Radiotherapy has a limited but re-emerging role in the management of recurrent epithelial ovarian cancer. We reviewed the published evidence and analysed our own institutional cohort of patients treated with radiotherapy for locoregionally recurrent disease after failure of systemic treatment.
Methods: A retrospective audit of patients treated with radiotherapy for recurrent ovarian cancer at our institution (1997–2015) was analysed. Kaplan–Meier methodology was used to estimate disease-free survival (DFS) and overall survival (OS) after radiotherapy in the 41 evaluable patients, after excluding 18 cases that did not meet eligibility criteria.
Results: Median DFS after radiotherapy was 8.5 months (95% CI, lower bound 5.5 months; upper bound not reached). Median OS measured from the start of radiotherapy was 28.3 months (95% CI 13.4–43.2 months), with actuarial 1-, 2- and 3-year OS of 82%, 57% and 40% respectively. Radiotherapy doses of 40–55 Gy (predominantly 45 Gy in 20–25 fractions) were used, consistent with contemporary involved-field radiotherapy practice.
Conclusion: In carefully selected patients with locoregionally recurrent ovarian cancer, radiotherapy can produce meaningful disease-free intervals and encouraging survival outcomes, consistent with the wider published literature. Patient selection — by resectability, performance status, and response to systemic therapy — remains the key determinant of benefit.

ovarian cancer; recurrence; radiotherapy; involved-field radiotherapy

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