[en] Purpose: To retrospectively review our experience using radiation therapy as a palliative treatment in ovarian carcinoma. Methods and Materials: Eighty patients who received radiation therapy for ovarian carcinoma between 1983 and 1998 were reviewed. The indications for radiation therapy, radiation therapy techniques, details, tolerance, and response were recorded. A complete response required complete resolution of the patient's symptoms, radiographic findings, palpable mass, or CA-125 level. A partial response required at least 50% resolution of these parameters. The actuarial survival rates from initial diagnosis and from the completion of radiation therapy were calculated. Results: The median age of the patients was 67 years (range 26 to 90 years). A median of one laparotomy was performed before irradiation. Zero to 20 cycles of a platinum-based chemotherapy regimen were delivered before irradiation (median = 6 cycles). The reasons for palliative treatment were: pain (n=22), mass (n=23), obstruction of ureter, rectum, esophagus, or stomach (n=12), a positive second-look laparotomy (n=9), ascites (n=8), vaginal bleeding (n=6), rectal bleeding (n=1), lymphedema (n=3), skin involvement (n=1), or brain metastases with symptoms (n=11). Some patients received treatment for more than one indication. Treatment was directed to the abdomen or pelvis in 64 patients, to the brain in 11, and to other sites in 5. The overall response rate was 73%. Twenty-eight percent of the patients experienced a complete response of their symptoms, palpable mass, and/or CA-125 level. Forty-five percent had a partial response. Only 11% suffered progressive disease during therapy that required discontinuation of the treatment. Sixteen percent had stable disease. The duration of the responses and stable disease lasted until death except in 10 patients who experienced recurrence of their symptoms between 1 and 21 months (median = 9 months). The 1-, 2-, 3-, and 5-year actuarial survival rates from diagnosis were 89%, 73%, 42%, and 33%, respectively. The survival rates calculated from the completion of radiotherapy were 39%, 27%, 13%, and 10%, respectively. Five percent of patients experienced Grade 3 diarrhea, vomiting, myelosuppression, or fatigue. Fourteen percent of patients experienced Grade 1 or 2 diarrhea, 19% experienced Grade 1 or 2 nausea and vomiting, and 11% had Grade 1 or 2 myelosuppression. Conclusions: In this series of radiation therapy for advanced ovarian carcinoma, the response, survival, and tolerance rates compare favorably to those reported for current second- and third-line chemotherapy regimens. Cooperative groups should consider evaluating prospectively the use of radiation therapy before nonplatinum and/or nonpaclitaxel chemotherapy in these patients

[en] •We evaluated the added value of a USPIO agent (Ferumoxtran-10) to MRI evaluation of LN metastasis in loco-regionally advanced cervical cancer in a multicenter trial.•There was no significant difference in the accuracy of f-10 MRI as compared to standard MRI to detect LN metastasis in advanced cervical cancer (P > 0.05).•F-10 MRI increased sensitivity of MRI to detect metastasis in small (<8 mm) LNs but at the expense of lower specificity.•Mean size of the largest metastatic focus in the LN on pathology was 13.7 mm in the abdomen and 18.8 mm in the pelvis (P = 0.018). We evaluated the added value of a USPIO agent (Ferumoxtran-10) to MRI evaluation of LN metastasis in loco-regionally advanced cervical cancer in a multicenter trial. There was no significant difference in the accuracy of f-10 MRI as compared to standard MRI to detect LN metastasis in advanced cervical cancer (P > 0.05). F-10 MRI increased sensitivity of MRI to detect metastasis in small (<8 mm) LNs but at the expense of lower specificity. Mean size of the largest metastatic focus in the LN on pathology was 13.7 mm in the abdomen and 18.8 mm in the pelvis (P = 0.018). To assess if ferumoxtran-10 (f-10) improves accuracy of MRI to detect lymph node (LN) metastasis in advanced cervical cancer. F-10 MRI component of an IRB approved HIPAA compliant ACRIN/GOG trial was analyzed. Patients underwent f-10 MRI followed by extra-peritoneal or laparoscopic pelvic and abdominal lymphadenectomy. F-10-sensitive sequences were T2* GRE sequences with TE of 12 and 21. Seven independent blinded readers reviewed f-10-insensitive sequences and all sequences in different sessions. Region correlations were performed between pathology and MRI for eight abdomen and pelvis regions. Sensitivity and specificity were calculated at participant level. Reference standard is based on pathology result of surgically removed LNs. Among 43 women enrolled in the trial between September 2007 and November 2009, 33 women (mean age 49 ± 11 years old) with advanced cervical cancer (12 IB2, 3 IIA, 15 IIB and 3 IIIB, 29 squamous cell carcinomas, 32 grade 2 or 3) were evaluable. Based on histopathology, LN metastasis was 39% in abdomen and 70% in pelvis. Sensitivity of all sequence review in pelvis, abdomen, and combined were 83%, 60%, and 86%, compared with 78%, 54%, and 80% for f-10 insensitive sequences (P: 0.24, 0.44 and 0.14, respectively). Mean diameter of the largest positive focus on histopathology was 13.7 mm in abdomen and 18.8 mm in pelvis (P = 0.018). Specificities of all sequence review in pelvis, abdomen, and combined were 48%, 75%, and 43%, compared with 75%, 83%, and 73% (P: 0.003, 0.14, 0.002 respectively) for f-10 insensitive sequences. Addition of f-10 increased MRI sensitivity to detect LN metastasis in advanced cervical cancer. Increased sensitivity did not reach statistical significance and was at the expense of lower specificity