Is there a role for radiation therapy in the treatment of recurrent ovarian cancer?
Ovarian cancer is a radiation-sensitive disease; in other words, cancer cells tend to respond quite nicely to radiation. The biggest problem that we have in ovarian cancer is that you have such a large area that you need to treat. The whole abdominal cavity from above the liver down deep in the pelvis is the area that’s at risk because as the cancer cells shed from the surface of the ovary, they can float throughout the abdominal cavity and settle down at any point. To effectively treat the vast majority of patients who have disease that has spread to the upper abdomen, you have to treat the whole abdomen. The problem is that many of the normal tissues are more sensitive to radiation than the cancer cells, such as the kidney and liver. Back in the old days, you had what we called whole abdomen radiation (WAR), where you really did radiate the whole abdomen. This was associated with a lot of toxicity, especially gastrointestinal toxicity, etc. But over the years there have been improvem
