A re-evaluation of the role of preoperative irradiation is indicated in the management of carcinoma of the ovary. The patient should be accurately staged and this can only be achieved by laparotomy. At this time, a biopsy is performed. For Stage I, surgical extirpation of the tumor and removal of the pelvic organs is adequate treatment. Chemotherapy is administered if there is operative spill or ascites. In Stage II, no further surgery is performed initially other than biopsy. Chemotherapy, both intracavitary and systemic, may be administered if there is ascites and/or operative spill. The patient should then be given radical radiation therapy of supervoltage or megavoltage quality. In our experience, doses of 5,000-5,500 r to the pelvis are well tolerated at a rate of slightly less than 1,000 r per week in 4 to 5 fractions weekly, and are sufficient for preoperative purposes. In Stage III, the management is similar to that in Stage II. Abdominal implants have been at times controlled by treatment to the pelvis only. If treatment to the upper abdomen is elected, lower dose levels than that administered to the pelvis are in order. Doses above 3,000 r are poorly tolerated and morbidity is increased. In Stages II and III, the patient should be examined carefully during and following radiation therapy to ascertain when the maximum regression of the tumor has occurred, and re-exploration should not be performed any earlier than 4 weeks after the completion of radiation therapy. Even if there is total disappearance of tumor, the patient should be re-explored. A thorough diagnostic study should be performed before re-exploration. The patient should have a chest roentgenogram and if this is suspect, a tomographic study of the chest. Blood chemistries and a liver scan should be performed in an effort to rule out the presence of metastases. If these studies are not indicative of metastases, the patient is submitted to surgery. At the time of surgery, complete removal of the tumor should be performed along with complete removal of the pelvic organs. In Stage IV disease, surgery should be limited only to achieve palliation. Likewise, radiation therapy is indicated only if there is a possibility of providing palliation. Chemotherapy may add to long-term and comfortable survival for many of these patients.2,4,15 Dr. James A. Corscaden has stated, "Certainly the partial removal of ovarian carcinoma, and subsequent irradiation, has not given very satisfactory results. The other procedure (that is, preoperative irradiation) would at least be worth trying."13