CYBERKNIFE TREATMENT IN OVARIAN CARCINOMA
A 60-year-old female with a history of Stage IV ovarian
carcinoma presented with rising CA-125 levels (21.1 U/ml to 34.4 U/ml),
signifying a probable ovarian carcinoma recurrence. Subsequent MRI showed a 2.8
x 2.5 cm nodule in the region of the left upper vaginal cuff which was
confirmed by bimanual examination. Initial diagnosis of Stage IV ovarian
carcinoma was made six years earlier when the patient presented with
right-sided pleural effusion and CA-125 of 1482 U/ml. An exploratory laparotomy
was done and an omental cake, peritoneal studding and a nodule adjacent to the
rectosigmoid were resected. Pathology showed poorly differentiated serous
papillary ovarian carcinoma.
Over the next four
years the patient underwent multiple rounds of chemotherapy as well as stem
cell transplant and additional surgical resection in the effort to control her
disease. The patient’s latest chemotherapy was prematurely discontinued when
she experienced a severe anaphylactoid reaction. At that time the decision was
made to follow her closely with imaging and CA-125 measurements.
CyberKnife® Treatment Rationale
Epithelial ovarian
cancer is the leading cause of death among women. More than 70% of women with
epithelial ovarian cancer have Stage III or IV disease at the time of diagnosis
1 Adjuvant chemotherapy is recommended for all patients with
advanced stage ovarian cancer after appropriate surgery. However, more than 70%
of patients relapse, with a median time to progression of less than 2 years.
2 Secondary surgery for recurrent patients has not
significantly improved survival. Radiation therapy has improved survival in a
subset of patients with chemotherapy-refractory disease, particularly those
patients with minimal residual or relapsed disease to the pelvis, and has
provided good palliation in patients with local abdominopelvic symptoms.
3 This patient presented with a recurrent ovarian cancer in
the left vaginal cuff. Due to the patient’s medical history, she was not a
candidate for further chemotherapy or surgery. Nevertheless, the left vaginal
cuff recurrence was and had always been the only site of recurrence in this
patient, therefore aggressive definitive care was indicated.
The use of stereotactic body radiotherapy as an alternative
to brachytherapy for gynecologic tumors has been reported to achieve excellent
local control rates with minimal toxicities.
4 offered a minimally
invasive method for delivering hypofractionated radiation to the left vaginal
cuff of a patient who had failed two surgical resections and numerous cycles of
chemotherapy.
Source : http://www.cyberknifetampabay.org/
To know more aboutcancer treatment at Apollo speciality hospital kindly write to me at lakshmipriya_b@apollohospitals.com or call 9940675877
