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Radiation therapy for vulvar cancer: consensus technical guidelines of the GINECOR working group of the Spanish Society of Radiation Oncology. Part 2: radiotherapy recommendations

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Abstract

Purpose

The present consensus statement was developed by the GINECOR working group on behalf of the Spanish Society of Radiation Oncology (SEOR). This document provides an up-to-date review of the technical aspects in radiation treatment of vulvar cancer.

Methods

A two-round modified Delphi study was conducted to reach consensus on the appropriateness of technical aspects of external beam radiotherapy and brachytherapy. Three clinical scenarios were proposed: adjuvant treatment of vulvar cancer, radiation treatment of locally advanced vulvar carcinoma and locoregional recurrences. After the first round, an extensive analysis of current medical literature from peer-reviewed journal was performed to define evidence-based treatment options. In the second round, participants were asked to indicate their level of agreement with the preliminary recommendations according to the GRADE (Grade of Recommendation, Assessment, Development, and Evaluation) criteria, as follows: strongly agree; agree; neither agree nor disagree; disagree and strongly disagree.

Results

The main recommendations on external beam radiotherapy and brachytherapy, both in adjuvant setting and local advanced disease are summarized. Recommendations include treatment technique, treatment volume, and doses in target and organs at-risk. Taking into consideration the different clinical scenarios of recurrent disease, the radiation treatment should be individualized.

Conclusions

In the absence of robust clinical data, these recommendations may help to select the optimal radiotherapy approach for this relatively rare cancer.

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References

  1. Woelber L, Eulenburg C, Kosse J, Neuser P, Heiss C, Hantschmann P, et al. AGO-CaRE 1 investigators. Predicting the course of disease in recurrent vulvar cancer–a subset analysis of the AGO-CaRE-1 study. Gynecol Oncol. 2019;154(3):571–6. https://doi.org/10.1016/j.ygyno.2019.07.009. (Epub 2019 Jul 17 PMID: 31324454).

    Article  PubMed  Google Scholar 

  2. Oonk MHM, Planchamp F, Baldwin P, Bidzinski M, Brännström M, Landoni F, et al. European society of gynaecological oncology guidelines for the management of patients with vulvar cancer. Int J Gynecol Cancer. 2017;27(4):832–7. https://doi.org/10.1097/IGC.0000000000000975. (PMID: 28441255).

    Article  PubMed  Google Scholar 

  3. Kellas-Ślęczka S, Białas B, Fijałkowski M, Wojcieszek P, Szlag M, Cholewka A, et al. Interstitial high-dose-rate brachytherapy in locally advanced and recurrent vulvar cancer. J Contemp Brachytherapy. 2016;8(1):32–40. https://doi.org/10.5114/jcb.2016.58081. (Epub 2016 Feb 29 PMID: 26985195; PMCID: PMC4793072).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Laliscia C, Gadducci A, Montrone S, Tana R, Morganti R, Fabrini MG, et al. Radiotherapy as definitive treatment of patients with primary vulvar carcinoma unfit for surgery and with recurrent vulvar carcinoma after primary radical surgery: results of a retrospective single-center study. Anticancer Res. 2016;36(1):387–91 (PMID: 26722070).

    CAS  PubMed  Google Scholar 

  5. Pohar S, Hoffstetter S, Peiffert D, Luporsi E, Pernot M. Effectiveness of brachytherapy in treating carcinoma of the vulva. Int J Radiat Oncol Biol Phys. 1995;32(5):1455–60. https://doi.org/10.1016/0360-3016(95)00109-C. (PMID: 7635788).

    Article  CAS  PubMed  Google Scholar 

  6. Lancellotta V, Macchia G, Garganese G, Fionda B, Fragomeni SM, D’Aviero A, et al. The role of brachytherapy (interventional radiotherapy) for primary and/or recurrent vulvar cancer: a Gemelli VulCan multidisciplinary team systematic review. Clin Transl Oncol. 2021;23(8):1611–9. https://doi.org/10.1007/s12094-021-02557-1. (Epub 2021 Mar 1 PMID: 33650029.71).

    Article  CAS  PubMed  Google Scholar 

  7. Mahantshetty U, Naga P, Engineer R, Sastri S, Ghadi Y, Upreti U, et al. Clinical outcome of high-dose-rate interstitial brachytherapy in vulvar cancer: a single institutional experience. Brachytherapy. 2017;16(1):153–60. https://doi.org/10.1016/j.brachy.2016.10.003. (Epub 2016 Nov 19 PMID: 27876410).

    Article  PubMed  Google Scholar 

  8. Castelnau-Marchand P, Escande A, Mazeron R, Bentivegna E, Cavalcanti A, Gouy S, et al. Brachytherapy as part of the conservative treatment for primary and recurrent vulvar carcinoma. Brachytherapy. 2017;16(3):518–25. https://doi.org/10.1016/j.brachy.2017.01.005. (Epub 2017 Mar 3 PMID: 28262516).

    Article  CAS  PubMed  Google Scholar 

  9. Palma DA, Olson R, Harrow S, Gaede S, Louie AV, Haasbeek C, et al. Stereotactic ablative radiotherapy for the comprehensive treatment of oligometastatic cancers: long-term results of the SABR-COMET phase ii randomized trial. J Clin Oncol. 2020;38(25):2830–8. https://doi.org/10.1200/JCO.20.00818. (Epub 2020 Jun 2 PMID: 32484754; PMCID: PMC7460150).

    Article  PubMed  PubMed Central  Google Scholar 

  10. Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: How to decide its appropriateness. World J Methodol. 2021;11(4):116–129. https://doi.org/10.5662/wjm.v11.i4.116. PMID: 34322364; PMCID: PMC8299905.

  11. Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008–15 (PMID: 11095242).

    CAS  PubMed  Google Scholar 

  12. Zapardiel I, Iacoponi S, Coronado PJ, Zalewski K, Chen F, Fotopoulou C, et al. VULCAN Study coinvestigators. Prognostic factors in patients with vulvar cancer: the VULCAN study. Int J Gynecol Cancer. 2020;30(9):1285–91. https://doi.org/10.1136/ijgc-2019-000526. (Epub 2020 Jun 22 Erratum in: Int J Gynecol Cancer 2020 Dec;30(12):2023 PMID: 32571891).

    Article  PubMed  Google Scholar 

  13. Pirot F, Chaltiel D, Ouldamer L, Touboul C, Raimond E, Carcopino X, et al. Patterns of first recurrence and outcomes in surgically treated women with vulvar cancer: results from FRANCOGYN study group. J Gynecol Obstet Hum Reprod. 2020;49(9):101775. https://doi.org/10.1016/j.jogoh.2020.101775. (Epub 2020 May 8 PMID: 32438137).

    Article  PubMed  Google Scholar 

  14. Te Grootenhuis NC, Pouwer AW, de Bock GH, Hollema H, Bulten J, van der Zee AGJ, et al. Margin status revisited in vulvar squamous cell carcinoma. Gynecol Oncol. 2019;154(2):266–75. https://doi.org/10.1016/j.ygyno.2019.05.010. (Epub 2019 May 18 PMID: 31109660).

    Article  Google Scholar 

  15. Mahner S, Jueckstock J, Hilpert F, Neuser P, Harter P, de Gregorio N, et al. AGO-CaRE 1 investigators. Adjuvant therapy in lymph node-positive vulvar cancer: the AGO-CaRE-1 study. J Natl Cancer Inst. 2015;107(3):426. https://doi.org/10.1093/jnci/dju426. (PMID: 25618900; PMCID: PMC4356703).

    Article  CAS  Google Scholar 

  16. Oonk MHM, Slomovitz B, Baldwin PJW, van Doorn HC, van der Velden J, de Hullu JA, et al. Radiotherapy versus inguinofemoral lymphadenectomy as treatment for vulvar cancer patients with micrometastases in the sentinel node: results of GROINSS-V II. J Clin Oncol. 2021;39(32):3623–32. https://doi.org/10.1200/JCO.21.00006.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Gill BS, Bernard ME, Lin JF, Balasubramani GK, Rajagopalan MS, Sukumvanich P, et al. Impact of adjuvant chemotherapy with radiation for node-positive vulvar cancer: a national cancer data base (NCDB) analysis. Gynecol Oncol. 2015;137(3):365–72. https://doi.org/10.1016/j.ygyno.2015.03.056. (Epub 2015 Apr 11 PMID: 25868965).

    Article  PubMed  Google Scholar 

  18. Rydzewski NR, Kanis MJ, Donnelly ED, Lurain JR, Strauss JB. Role of adjuvant external beam radiotherapy and chemotherapy in one versus two or more node-positive vulvar cancer: a national cancer database study. Radiother Oncol. 2018;129(3):534–9. https://doi.org/10.1016/j.radonc.2018.03.023. (Epub 2018 Apr 6 PMID: 29631932).

    Article  PubMed  Google Scholar 

  19. Woelber L, Prieske K, Eulenburg CZ, Corradini S, Petersen C, Bommert M, et al. Adjuvant radiotherapy and local recurrence in vulvar cancer–a subset analysis of the AGO-CaRE-1 study. Gynecol Oncol. 2022;164(1):68–75. https://doi.org/10.1016/j.ygyno.2021.11.004. (Epub 2021 Nov 16 PMID: 34794839).

    Article  CAS  PubMed  Google Scholar 

  20. Homesley HD, Bundy BN, Sedlis A, Adcock L. Radiation therapy versus pelvic node resection for carcinoma of the vulva with positive groin nodes. Obstet Gynecol. 1986;68(6):733–40 (PMID: 3785783).

    CAS  PubMed  Google Scholar 

  21. van der Velden J, Pleunis N, Barlow E, Zijlmans H, de Hullu J, Hacker NF, et al. Radiotherapy is not indicated in patients with vulvar squamous cell carcinoma and only one occult intracapsular groin node metastasis. Gynecol Oncol. 2021;160(1):128–33. https://doi.org/10.1016/j.ygyno.2020.10.008. (Epub 2020 Oct 13 PMID: 33067000).

    Article  PubMed  Google Scholar 

  22. Moore DH, Thomas GM, Montana GS, Saxer A, Gallup DG, Olt G, et al. Preoperative chemoradiation for advanced vulvar cancer: a phase II study of the gynecologic oncology group. Int J Radiat Oncol Biol Phys. 1998;42(1):79–85. https://doi.org/10.1016/s0360-3016(98)00193-x. (PMID:9747823.59).

    Article  CAS  PubMed  Google Scholar 

  23. Montana GS, Thomas GM, Moore DH, Saxer A, Mangan CE, Lentz SS, et al. Preoperative chemo-radiation for carcinoma of the vulva with N2/N3 nodes: a gynecologic oncology group study. Int J Radiat Oncol Biol Phys. 2000;48(4):1007–13. https://doi.org/10.1016/s0360-3016(00)00762-8. (PMID: 11072157).

    Article  CAS  PubMed  Google Scholar 

  24. Moore DH, Ali S, Koh WJ, Michael H, Barnes MN, McCourt CK, et al. A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a gynecologic oncology group study. Gynecol Oncol. 2012;124(3):529–33. https://doi.org/10.1016/j.ygyno.2011.11.003. (Epub 2011 Nov 9 PMID: 22079361).

    Article  CAS  PubMed  Google Scholar 

  25. Natesan D, Hong JC, Foote J, Sosa JA, Havrilesky L, Chino J. Primary versus preoperative radiation for locally advanced vulvar cancer. Int J Gynecol Cancer. 2017;27(4):794–804. https://doi.org/10.1097/IGC.0000000000000938. (PMID: 28333840).

    Article  PubMed  Google Scholar 

  26. Gaffney DK, King B, Viswanathan AN, Barkati M, Beriwal S, Eifel P, et al. Consensus recommendations for radiation therapy contouring and treatment of vulvar carcinoma. Int J Radiat Oncol Biol Phys. 2016. https://doi.org/10.1016/j.ijrobp.2016.02.043. (Epub 2016 Feb 21 PMID: 27130794; PMCID: PMC5189987).

    Article  PubMed  PubMed Central  Google Scholar 

  27. Small W Jr, Bosch WR, Harkenrider MM, Strauss JB, Abu-Rustum N, Albuquerque KV, et al. NRG oncology/RTOG consensus guidelines for delineation of clinical target volume for intensity modulated pelvic radiation therapy in postoperative treatment of endometrial and cervical cancer: an update. Int J Radiat Oncol Biol Phys. 2021;109(2):413–24. https://doi.org/10.1016/j.ijrobp.2020.08.061. (Epub 2020 Sep 6 PMID: 32905846; PMCID: PMC7856050).

    Article  PubMed  Google Scholar 

  28. GOG 279: NRG Oncology. A phase II trial evaluating cisplatin (NSC #119875) and gemcitabine (NSC #613327) concurrent with intensity modulated radiation therapy (IMRT) in the treatment of locally advanced squamous cell carcinoma of the vulva, 2020. Available: https://www.nrgoncology.org/Clinical-Trials/Protocol/gog-0279? filter=gog-0279 [Accessed 27 May 2021].

  29. Ling DC, Thomas J, Vargo JA, Orr BC, Sukumvanich P, Berger JL, et al. PET-CT directed IMRT-based chemoradiation for locally advanced vulvar cancer–analysis of regional recurrence patterns. Int J Radiat Oncol Biol Phys. 2020;108: e469.

    Article  Google Scholar 

  30. Beriwal S, Coon D, Heron DE, Kelley JL, Edwards RP, Sukumvanich P, et al. Preoperative intensity-modulated radiotherapy and chemotherapy for locally advanced vulvar carcinoma. Gynecol Oncol. 2008;109(2):291–5. https://doi.org/10.1016/j.ygyno.2007.10.026. (PMID: 18455637).

    Article  PubMed  Google Scholar 

  31. Beriwal S, Shukla G, Shinde A, Heron DE, Kelley JL, Edwards RP, et al. Preoperative intensity modulated radiation therapy and chemotherapy for locally advanced vulvar carcinoma: analysis of pattern of relapse. Int J Radiat Oncol Biol Phys. 2013;85(5):1269–74. https://doi.org/10.1016/j.ijrobp.2012.11.012. (Epub 2012 Dec 27 PMID: 23273997).

    Article  PubMed  Google Scholar 

  32. Rao YJ, Chundury A, Schwarz JK, Hassanzadeh C, DeWees T, Mullen D, et al. Intensity modulated radiation therapy for squamous cell carcinoma of the vulva: treatment technique and outcomes. Adv Radiat Oncol. 2017;2(2):148–58. https://doi.org/10.1016/j.adro.2017.02.006.PMID:28740926;PMCID:PMC5514255.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Stecklein SR, Frumovitz M, Klopp AH, Gunther JR, Eifel PJ. Effectiveness of definitive radiotherapy for squamous cell carcinoma of the vulva with gross inguinal lymphadenopathy. Gynecol Oncol. 2018;148(3):474–9. https://doi.org/10.1016/j.ygyno.2018.01.007. (Epub 2018 Jan 12 PMID: 29336837).

    Article  PubMed  Google Scholar 

  34. Rishi A, Rollins M, Ahmed KA, Hunt DC, Sarkar P, Fernandez DC, et al. High-dose intensity-modulated chemoradiotherapy in vulvar squamous cell carcinoma: outcome and toxicity. Gynecol Oncol. 2020;156(2):349–56. https://doi.org/10.1016/j.ygyno.2019.11.027. (Epub 2019 Nov 23 PMID: 31771865).

    Article  CAS  PubMed  Google Scholar 

  35. Rao YJ, Chin RI, Hui C, Mutch DG, Powell MA, Schwarz JK, et al. Improved survival with definitive chemoradiation compared to definitive radiation alone in squamous cell carcinoma of the vulva: a review of the national cancer database. Gynecol Oncol. 2017;146(3):572–9. https://doi.org/10.1016/j.ygyno.2017.06.022. (Epub 2017 Jun 27 PMID: 28662775).

    Article  PubMed  Google Scholar 

  36. Chapman BV, Gill BS, Viswanathan AN, Balasubramani GK, Sukumvanich P, Beriwal S. Adjuvant radiation therapy for margin-positive vulvar squamous cell carcinoma: defining the ideal dose-response using the national cancer data base. Int J Radiat Oncol Biol Phys. 2017;97(1):107–17. https://doi.org/10.1016/j.ijrobp.2016.09.023. (Epub 2016 Sep 24 PMID: 27843030).

    Article  PubMed  Google Scholar 

  37. Laliscia C, Fabrini MG, Cafaro I, Barcellini A, Baldaccini D, Miniati M, et al. Adjuvant radiotherapy in high-risk squamous cell carcinoma of the vulva: a two-institutional Italian experience. Oncol Res Treat. 2017;40(12):778–83. https://doi.org/10.1159/000479876. (Epub 2017 Nov 29 PMID: 29183034).

    Article  PubMed  Google Scholar 

  38. Elledge CR, Beriwal S, Chargari C, Chopra S, Erickson BA, Gaffney DK, et al. Radiation therapy for gynecologic malignancies during the COVID-19 pandemic: international expert consensus recommendations. Gynecol Oncol. 2020;158(2):244–53. https://doi.org/10.1016/j.ygyno.2020.06.486. (Epub 2020 Jun 15 PMID: 32563593; PMCID: PMC7294297).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Kachnic LA, Winter K, Myerson RJ, Goodyear MD, Willins J, Esthappan J, et al. RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal. Int J Radiat Oncol Biol Phys. 2013;86(1):27–33. https://doi.org/10.1016/j.ijrobp.2012.09.023. (Epub 2012 Nov 12 PMID: 23154075; PMCID: PMC3619011).

    Article  CAS  PubMed  Google Scholar 

  40. Klopp AH, Moughan J, Portelance L, Miller BE, Salehpour MR, Hildebrandt E, et al. Hematologic toxicity in RTOG 0418: a phase 2 study of postoperative IMRT for gynecologic cancer. Int J Radiat Oncol Biol Phys. 2013;86(1):83–90. https://doi.org/10.1016/j.ijrobp.2013.01.017. (PMID:23582248;PMCID:PMC4572833).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Viswanathan AN, Moughan J, Miller BE, Xiao Y, Jhingran A, Portelance L, et al. NRG oncology/RTOG 0921: a phase 2 study of postoperative intensity-modulated radiotherapy with concurrent cisplatin and bevacizumab followed by carboplatin and paclitaxel for patients with endometrial cancer. Cancer. 2015;121(13):2156–63. https://doi.org/10.1002/cncr.29337. (Epub 2015 Apr 6 PMID: 25847373; PMCID: PMC4685031).

    Article  CAS  PubMed  Google Scholar 

  42. Tan LT, Tanderup K, Kirisits C, de Leeuw A, Nout R, Duke S, et al. Image-guided adaptive radiotherapy in cervical cancer. Semin Radiat Oncol. 2019;29(3):284–98. https://doi.org/10.1016/j.semradonc.

    Article  Google Scholar 

  43. Thörnqvist S, Hysing LB, Tuomikoski L, Vestergaard A, Tanderup K, Muren LP, et al. Adaptive radiotherapy strategies for pelvic tumors—a systematic review of clinical implementations. Acta Oncol (Madr). 2016;55(8):943–58. https://doi.org/10.3109/0284186X.2016.1156738.

    Article  CAS  Google Scholar 

  44. Shenker RF, Rodrigues A, Eckrich C, DÁnna R, Niedzwiecki D, Craciunescu OI, et al. Adaptive PET radiation therapy in patients with locally advanced vulvar cancer: a prospective study. Int J Radiat Oncol Biol Phys. 2022;114(3):e729.

    Article  Google Scholar 

  45. Yaney A, Healy E, Pan X, Martin D, Quick A. Clinical outcomes of distal vaginal and vulvar cancer treated with image-guided brachytherapy. J Contemp Brachytherapy. 2021;13(4):419–25. https://doi.org/10.5114/jcb.2021.108596. (Epub 2021 Aug 24 PMID: 34484356; PMCID: PMC8407257).

    Article  PubMed  PubMed Central  Google Scholar 

  46. Krempien RC, Daeuber S, Hensley FW, Wannenmacher M, Harms W. Image fusion of CT and MRI data enables improved target volume definition in 3D-brachytherapy treatment planning. Brachytherapy. 2003;2(3):164–71. https://doi.org/10.1016/S1538-4721(03)00133-8. (PMID: 15062139).

    Article  PubMed  Google Scholar 

  47. Cozma AI, Martell K, Ravi A, Barnes E, Donovan E, Paudel M, et al. Relationship of urethral dose and genitourinary toxicity among patients receiving vaginal high dose rate interstitial brachytherapy. Clin Oncol (R Coll Radiol). 2021;33(12):773–9. https://doi.org/10.1016/j.clon.2021.05.006. (Epub 2021 Jun 4 PMID: 34092463).

    Article  CAS  PubMed  Google Scholar 

  48. Rajagopalan MS, Kannan N, Kim H, Houser CJ, Beriwal S. Urethral dosimetry and toxicity with high-dose-rate interstitial brachytherapy for vaginal cancer. Brachytherapy. 2013;12(3):248–53. https://doi.org/10.1016/j.brachy.2012.10.005. (Epub 2013 Mar 1 PMID: 23453679).

    Article  PubMed  Google Scholar 

  49. Amsbaugh MJ, Bhatt N, Hunter T, Gaskins J, Parker L, Metzinger D, et al. Computed tomography-planned interstitial brachytherapy for locally advanced gynecologic cancer: outcomes and dosimetric predictors of urinary toxicity. Brachytherapy. 2016;15(1):49–56. https://doi.org/10.1016/j.brachy.2015.10.001. (Epub 2015 Nov 21 PMID: 26614237).

    Article  PubMed  Google Scholar 

  50. Siebert FA, Born T, Häring S, Seefeld F, Kovács G. A dosimetric analysis of interstitial intensity modulated implants for pelvic recurrences, base of tongue and orbita tumors with specific references to the ICRU-58. Radiother Oncol. 2006;79(3):298–303. https://doi.org/10.1016/j.radonc.2006.04.013. (Epub 2006 May 26 PMID: 16730084).

    Article  PubMed  Google Scholar 

  51. Mahantshetty U, Kalyani N, Engineer R, Chopra S, Jamema S, Ghadi Y, et al. Reirradiation using high-dose-rate brachytherapy in recurrent carcinoma of uterine cervix. Brachytherapy. 2014;13:548–53.

    Article  PubMed  Google Scholar 

  52. Mabuchi S, Takahashi R, Isohashi F, Yokoi T, Okazawa M, Sasano T, et al. Reirradiation using high-dose-rate interstitial brachytherapy for locally recurrent cervical cancer: a single institutional experience. Int J Gynecol Cancer. 2014;24:600–5.

    Article  Google Scholar 

  53. Zolciak-Siwinska A, Bijok M, Jonska-Gmyrek J, Kawczynska M, Kepka L, Bujko K, et al. HDR brachytherapy for the reirradiation of cervical and vaginal cancer: analysis of efficacy and dosage delivered to organs at risk. Gynecol Oncol. 2014;132:93–7.

    Article  PubMed  Google Scholar 

  54. Bockel S, Espenel S, Sun R, Dumas I, Gouy S, Morice P, et al. Image-guided brachytherapy for salvage reirradiation: a systematic review. Cancers. 2021;13:1226.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Tom MC, Joshi N, Vicini F, Chang AJ, Hong TS, Showalter TN, et al. The American brachytherapy society consensus statement on intraoperative radiation therapy. Brachytherapy. 2019;18(3):242–57. https://doi.org/10.1016/j.brachy.2019.01.015. (PMID: 31084904).

    Article  PubMed  Google Scholar 

  56. Martínez-Monge R, Valtueña Peydró G, Cambeiro M, Aramendía JM, Gimeno M, Santisteban M, et al. Perioperative high-dose-rate brachytherapy in locally advanced and recurrent gynecological cancer: final results of a Phase II trial. Brachytherapy. 2018;17(6):1045. https://doi.org/10.1016/j.brachy.2018.09.001.

    Article  PubMed  Google Scholar 

  57. Jablonska PA, Cambeiro M, Gimeno M, Aramendía JM, Mínguez JA, Alcázar JL, et al. Intraoperative electron beam radiotherapy and perioperative high-dose-rate brachytherapy in previously irradiated oligorecurrent gynecological cancer: clinical outcome analysis. Clin Transl Oncol. 2021;23(9):1934–41. https://doi.org/10.1007/s12094-021-02601-0. (Epub 2021 Apr 9 PMID: 33835408).

    Article  CAS  PubMed  Google Scholar 

  58. Zhang TW, Palma D, D’Souza D, Velker V, Mendez LC. Stereotactic ablative radiotherapy for recurrent or metastatic gynecological cancer: extending lives? Curr Treat Options Oncol. 2020;21(7):58. https://doi.org/10.1007/s11864-020-00748-6. (PMID: 32533272).

    Article  PubMed  Google Scholar 

  59. Kunos CA, Brindle J, Waggoner S, Zanotti K, Resnick K, Fusco N, et al. Phase II clinical trial of robotic stereotactic body radiosurgery for metastatic gynecologic malignancies. Front Oncol. 2012;5(2):181. https://doi.org/10.3389/fonc.2012.00181. (PMID:23227452;PMCID:PMC3514687).

    Article  Google Scholar 

  60. Yegya-Raman N, Cao CD, Hathout L, Girda E, Richard SD, Rosenblum NG, et al. Stereotactic body radiation therapy for oligometastatic gynecologic malignancies: a systematic review. Gynecol Oncol. 2020;159(2):573–80. https://doi.org/10.1016/j.ygyno.2020.08.010. (Epub 2020 Sep 9 PMID: 32917412).

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiation Oncology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain

    Sofia Cordoba Largo & Cristina de la Fuente Alonso

  2. Department of Radiation Oncology, La Paz University Hospital, Madrid, Spain

    Isabel Rodriguez Rodriguez & Belen Belinchon Olmeda

  3. Department of Radiation Oncology, Clinica Benidorm Hospital, Benidorm, Alicante, Spain

    Silvia Rodriguez Villalba

  4. Department of Radiation Oncology, Catalan Institut of Oncology, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain

    Dina Najjari Jamal

  5. Department of Radiation Oncology, Marqués de Valdecilla University Hospital, Santander, Spain

    Javier Anchuelo Latorre & Paola Andrea Navarrete Solano

  6. Department of Radiation Oncology, La Fe, University Hospital and Politécnico, Valencia, Spain

    Francisco Celada Alvarez

  7. Department of Radiation Oncology, Reina Sofía, University Hospital, Córdoba, Spain

    Sonia Garcia Cabezas

  8. Department of Radiation Oncology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain

    Luz Couselo Paniagua

  9. Department of Radiation Oncology, Complejo Hospitalario de Navarra, Pamplona, Spain

    Irene Martinez Montesinos & Elena Villafranca Iturre

  10. Department of Radiation Oncology, Consorcio Hospital General de Valencia, Valencia, Spain

    Dolores Farga Albiol

  11. Department of Radiation Oncology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain

    Maria Sanchez Belda

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  1. Sofia Cordoba Largo
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GINECOR (Spanish gynaecological tumors group of SEOR)

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Correspondence to Sofia Cordoba Largo.

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Cordoba Largo, S., Rodriguez Rodriguez, I., Rodriguez Villalba, S. et al. Radiation therapy for vulvar cancer: consensus technical guidelines of the GINECOR working group of the Spanish Society of Radiation Oncology. Part 2: radiotherapy recommendations. Clin Transl Oncol 25, 2169–2182 (2023). https://doi.org/10.1007/s12094-023-03101-z

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