SBRT (ablative radiotherapy) yields 95% 1-yr local control in oligorecurrent ovarian cancer

Stereotactic body radiation therapy (SBRT)—a high-dose, image-guided ablative radiotherapy—was tested in a Phase I 3+3 dose-escalation study (NCT03325634) for ovarian/fallopian tube/primary peritoneal cancers with ≤3 locoregional recurrences (n=15); dose escalated to 30 Gy/3 fractions with no dose-limiting toxicity. There were no grade ≥2 SBRT-related toxicities; 1-yr local control was 95%, 1-yr PFS 45%, and 1-yr OS 100%. Two-thirds received SBRT instead of systemic therapy and, of these, 70% remained off systemic therapy at 1 year with stable global QOL. Compared with current systemic SOC—platinum-resistant mPFS ≈3.4–6.7 months with chemo±bevacizumab (AURELIA) and platinum-sensitive mPFS ≈9–12.4 months with platinum doublets±bevacizumab (CALYPSO/OCEANS)—the 1-yr PFS rate and chemo-free interval suggest SBRT can secure durable local control while deferring chemotherapy in carefully selected patients.