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Gynecological Malignancies

  • Jennifer Croke
  • Eric Leung
  • Anthony Fyles
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Surgical, technical, and biological advancements in treatment have improved clinical outcomes for patients with gynecological malignancies. Despite this a significant proportion will relapse locally, requiring multidisciplinary management. Patients who received definitive radiotherapy as primary treatment are ideally treated with surgery; however, this is not always possible. Re-irradiation poses a therapeutic dilemma, as the desire for local control must be weighed against the potential risks associated with re-treatment. A patient’s suitability for radical re-treatment is determined by multiple factors: clinical performance status, symptomatology, site of recurrence, previous radiotherapy delivery technique, dose/fractionation, radiation-related toxicities, and disease extent. With improvement in technologies, an aggressive approach is now feasible and worth pursuing in carefully selected patients, where not only palliation of local symptoms is possible but also long-term local control. In this review, the clinical, tumor, and radiobiological factors as well as technological considerations are highlighted. A treatment algorithm for patients presenting for consideration of re-irradiation for recurrent gynecological malignancy is also presented.

Keywords

Locoregional Recurrence Gynecological Malignancy Stereotactic Radiotherapy Rectovaginal Fistula Isodose Line 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Radiation Medicine ProgramPrincess Margaret Cancer CentreTorontoCanada
  2. 2.Department of Radiation OncologyUniversity of TorontoTorontoCanada
  3. 3.Department of Radiation OncologyOdette Cancer CenterTorontoCanada

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