Stereotactic Body Radiation Therapy for Gynecologic Malignancies: A Case-Based Radiosurgery Society Practice Review. 2024

Colton Ladbury, and Mark H Sueyoshi, and Nellie M Brovold, and Ritesh Kumar, and Therese Y Andraos, and Emile Gogineni, and Minsun Kim, and Ann Klopp, and Kevin Albuquerque, and Charles Kunos, and Eric Leung, and Constantine Mantz, and Tithi Biswas, and Sushil Beriwal, and William Small, and Beth Erickson, and David Gaffney, and Simon S Lo, and Akila N Viswanathan
Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California. Electronic address: coltonladburyradonc@gmail.com.

OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D005833 Genital Neoplasms, Female Tumor or cancer of the female reproductive tract (GENITALIA, FEMALE). Gynecologic Neoplasms,Female Genital Neoplasms,Neoplasms, Female Genital,Neoplasms, Gynecologic,Female Genital Neoplasm,Genital Neoplasm, Female,Gynecologic Neoplasm,Neoplasm, Female Genital,Neoplasm, Gynecologic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D016634 Radiosurgery A radiological stereotactic technique developed for cutting or destroying tissue by high doses of radiation in place of surgical incisions. It was originally developed for neurosurgery on structures in the brain and its use gradually spread to radiation surgery on extracranial structures as well. The usual rigid needles or probes of stereotactic surgery are replaced with beams of ionizing radiation directed toward a target so as to achieve local tissue destruction. Gamma Knife Radiosurgery,Linear Accelerator Radiosurgery,Stereotactic Body Radiotherapy,Stereotactic Radiosurgery,CyberKnife Radiosurgery,LINAC Radiosurgery,Radiosurgery, Gamma Knife,Radiosurgery, Linear Accelerator,Radiosurgery, Stereotactic,Stereotactic Radiation,Stereotactic Radiation Therapy,CyberKnife Radiosurgeries,Gamma Knife Radiosurgeries,LINAC Radiosurgeries,Linear Accelerator Radiosurgeries,Radiation Therapy, Stereotactic,Radiation, Stereotactic,Radiosurgery, CyberKnife,Radiosurgery, LINAC,Radiotherapy, Stereotactic Body,Stereotactic Body Radiotherapies,Stereotactic Radiation Therapies,Stereotactic Radiations,Stereotactic Radiosurgeries,Therapy, Stereotactic Radiation

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