Eighty-three patients with ovarian cancer who had undergone radiation therapy, chemotherapy, or both were evaluated. Eight patients had FIGO stage I, 12 had stage II, 61 had stage III, and two had stage IV disease. In 60 patients, radiation was delivered with open abdominopelvic field (30 Gy over 4 weeks), with or without a pelvic boost dose. Fifty-five patients received a combination of chemotherapeutic agents, and 30 received a single agent as initial therapy. The patients were divided into three groups. The 26 patients in group 1 received primary radiation therapy with or without adjuvant single-agent chemotherapy. The 34 patients in group 2 underwent radiation therapy after chemotherapy failed. The 23 patients in group 3 received combination chemotherapy. Nineteen patients (23%) achieved complete remission--eight from group 1, two from group 2, and nine from group 3. The 5-year actuarial survival for group 1 was 41% but was only 16% for both groups 2 and 3 combined (P = .026). Primary radiation therapy, with or without adjuvant single-agent chemotherapy, was superior to combination chemotherapy in patients with ovarian cancer.