Stereotactic Body Radiation Therapy for Gynecologic Malignancies: A Case-Based Radiosurgery Society Practice Review.

The use of stereotactic body radiation therapy (SBRT) for gynecologic malignancies is controversial. We discuss certain circumstances when highly precise SBRT may be a useful tool to consider in the management of selected patients. Case selection included the following scenarios, the first 2 with palliative intent, para-aortic nodal oligorecurrence of ovarian cancer, pelvic sidewall oligorecurrence of cervical cancer, and inoperable endometrial cancer boost after intensity modulated radiation to the pelvis treated with curative intent. Patient characteristics, fractionation, prescription dose, treatment technique, and dose constraints were discussed. Relevant literature to these cases was summarized to provide a framework for treatment of similar patients. Treatment of gynecologic malignancies with SBRT requires many considerations, including treatment intent, optimal patient selection, fractionation selection, tumor localization, and plan optimization. Although other treatment paradigms including conventionally fractionated radiation therapy and brachytherapy remain the standard-of-care for definitive treatment of gynecologic malignancies, SBRT may have a role in palliative cases or those where high doses are not required due to the unacceptable toxicity that may occur with SBRT. A case-based practice review was developed by the Radiosurgery Society to provide a practical guide to the common scenarios noted above affecting patients with gynecologic malignancies.

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure Sushil Beriwal reports employment by Varian, membership on the Xoft DSMB, and is a consultant for Elsevier ClinicalPath. Beth Erickson reports serving on the ASTRO Board of Directors as the Chair of the Educational Council. David Gaffney reports grant funding from Elekta and NCI UG1 LAPS and serving as chair of the Merck DSMC. Simon S. Lo reports grant funding from Kuni Foundation, Hutchinson Center, and Elekta, travel support from the Japanese Society for Radiation Oncology (JASTRO) and serves as Member of Board of Directors and National Medical Director of the Distinction in Practice in Stereotactic Radiotherapy Program for the Radiosurgery Society and Alternate Councilor for the American College of Radiology.