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Gynecologic Malignancies

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Intraoperative Irradiation

Part of the book series: Current Clinical Oncology ((CCO))

Abstract

The prognosis for women with locally advanced gynecologic tumors with direct tumor extension to pelvic sidewall structures or gross lymphatic spread to pelvic or para-aortic nodes is poor. Although high-dose external-beam radiation (EBRT) with or without brachytherapy is often utilized to treat primary locally advanced malignancies with some success, aggressive local therapy is often not considered in patients with locally advanced recurrent disease in whom standard radiation or surgical therapy has failed. This chapter summarizes the results of standard therapy for locally advanced gynecologic malignancies and presents data from series of patients treated with IORT containing regimens. The future potential of IORT in the management of locally advanced gynecologic malignancies is discussed.

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References

  1. Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P, et al. Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet. 1997;350(9077):535–40.

    PubMed  CAS  Google Scholar 

  2. Marcial VA, Marcial LV. Radiation therapy of cervical cancer. Cancer. 1993;71:1438–45.

    PubMed  CAS  Google Scholar 

  3. Jampolis S, Andras EJ, Fletcher GH. Analysis of sites and causes of failures of irradiation in invasive squamous cell carcinoma of the intact uterine cervix. Radiology. 1975;115:681–5.

    PubMed  CAS  Google Scholar 

  4. Morris M, Eifel PJ, Lu J, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med. 1999;340:1137–43.

    PubMed  CAS  Google Scholar 

  5. Rose PG, Bundy BN, Watkins EB, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340:1144–53.

    PubMed  CAS  Google Scholar 

  6. Whitney CW, Sause W, Bundy BN, et al. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol. 1999;17:1339–48.

    PubMed  CAS  Google Scholar 

  7. Eifel PJ, Winter K, Morris M, Levenback C, Grigsby PW, Cooper J, et al. Pelvic irradiation with concurrent chemotherapy versus pelvic and para-aortic irradiation for high-risk cervical cancer: an update of radiation therapy oncology group trial (RTOG) 90-01. J Clin Oncol. 2004;22(5):872–80.

    PubMed  CAS  Google Scholar 

  8. Perez CA, Fox S, Lockett MA, et al. Impact of dose in outcome of irradiation alone in carcinoma of the uterine cervix: analysis of two different methods. Int J Radiat Oncol Biol Phys. 1991;21:885–98.

    PubMed  CAS  Google Scholar 

  9. Perez CA, Kuske RR, Camel HM, et al. Analysis of pelvic tumor control and impact on survival in carcinoma of the uterine cervix treated with radiation therapy alone. Int J Radiat Oncol Biol Phys. 1988;14:613–21.

    PubMed  CAS  Google Scholar 

  10. Chism SE, Keys HM, Gillin MT. Carcinoma of the cervix: a time-dose analysis of control and complication. Am J Roentgenol. 1975;123:84–90.

    CAS  Google Scholar 

  11. Hanks GE, Herring DF, Kramer S. Patterns of care outcome studies – results of National Practice in Cancer of the Cervix. Cancer. 1983;51:959–67.

    PubMed  CAS  Google Scholar 

  12. Kottmeier HL, Gray MJ. Rectal and bladder injuries in relation to radiation dosage in carcinoma of cervix. Am J Obstet Gynecol. 1961;82:74–82.

    PubMed  CAS  Google Scholar 

  13. Perez CA, Breaux S, Bedwinek JM, et al. Radiation therapy alone in the treatment of carcinoma of the uterine cervix II: analysis of complications. Cancer. 1984;54:235–46.

    PubMed  CAS  Google Scholar 

  14. Unal A, Hamberger AD, Seski JC, Fletcher GH. An analysis of the severe complications of irradiation of carcinoma of the uterine cervix: treatment with intracavitary radium and parametrial irradiation. Int J Radiat Oncol Biol Phys. 1981;7:999–1004.

    PubMed  CAS  Google Scholar 

  15. Hamberger AD, Unal A, Gershenson DM, Fletcher GH. Analysis of the severe complications of irradiation of carcinoma of the cervix: whole pelvis irradiation and intracavitary radium. Int J Radiat Oncol Biol Phys. 1983;9:367–71.

    PubMed  CAS  Google Scholar 

  16. Potish RA, Downey GO, Adcock LL, Prem KA, Twiggs LB. The role of surgical debulking in cancer of the uterine cervix. Int J Radiat Oncol Biol Phys. 1989;17:979–84.

    PubMed  CAS  Google Scholar 

  17. Fletcher GH. Subclinical disease. Cancer. 1984;55:1274–84.

    Google Scholar 

  18. Stehman FB, Bundy BN, DiSaia PJ, Keys HM, Larson JE, Fowler WC. Carcinoma of the cervix treated with radiation therapy I: a multivariate analysis of prognostic variables in the Gynecologic Oncology Group. Cancer. 1991;67:2776–85.

    PubMed  CAS  Google Scholar 

  19. Komaki R, Mattingly RF, Hoffman RG, Barber SW, Satre R, Greenberg M. Irradiation of para-aortic lymph node metastases from carcinoma of the cervix or endometrium. Radiology. 1983;147:245–8.

    PubMed  CAS  Google Scholar 

  20. Berman ML, Keys H, Creasman W, DiSaia P, Bundy B, Blessing J. Survival and patterns of recurrence in cervical cancer metastatic to periaortic lymph nodes. Gynecol Oncol. 1984;19:8–16.

    PubMed  CAS  Google Scholar 

  21. Lovecchio JL, Averette HE, Donato D, Bell J. 5-year survival of patients with periaortic nodal metastases in clinical stage IB and IIA cervical carcinoma. Gynecol Oncol. 1989;34:43–5.

    PubMed  CAS  Google Scholar 

  22. Hughes RR, Brewington KC, Hanjani P, et al. Extended field irradiation for cervical cancer based on surgical staging. Gynecol Oncol. 1980;9:153–61.

    PubMed  CAS  Google Scholar 

  23. Potish R, Adcock L, Jones Jr T, et al. The morbidity and utility of periaortic radiotherapy in cervical carcinoma. Gynecol Oncol. 1983;15:1–9.

    PubMed  CAS  Google Scholar 

  24. Piver MS, Barlow MD, Krishnamsetty R. Five-year survival (with no evidence of disease) in patients with biopsy-confirmed aortic node metastasis from cervical carcinoma. Am J Obstet Gynecol. 1981;139:575–8.

    PubMed  CAS  Google Scholar 

  25. Wharton JT, Jones III HW, Jr Day TD, Rutledge FN, Fletcher GH. Preirradiation celiotomy and extended field irradiation for invasive carcinoma of the cervix. Obstet Gynecol. 1977;49:333–8.

    PubMed  CAS  Google Scholar 

  26. Alektiar KM. When and how should adjuvant radiation be used in early endometrial cancer? Semin Radiat Oncol. 2006;16(3):158–63.

    PubMed  Google Scholar 

  27. Danoff BF, McDay J, Louka M, Lewis GC, Lee J, Kramer S. Stage III endometrial carcinoma: analysis of patterns of failure and therapeutic implications. Int J Radiat Oncol Biol Phys. 1980;6:1491–5.

    PubMed  CAS  Google Scholar 

  28. Potish RA, Twiggs LB, Adcock LL, Prem KA. Role of whole abdominal radiation therapy in the management of endometrial cancer; prognostic importance of factors indicating peritoneal metastases. Gynecol Oncol. 1985;21:80–6.

    PubMed  CAS  Google Scholar 

  29. Bruckman JE, Bloomer WD, Marck A, Ehrmann RL, Knapp RC. Stage III adenocarcinom of the endometrium: two prognostic groups. Gynecol Oncol. 1980;9:12–7.

    PubMed  CAS  Google Scholar 

  30. Antoniades J, Brady LW, Lewis GC. The management of stage III carcinoma of the endometrium. Cancer. 1976;38:1838–42.

    PubMed  CAS  Google Scholar 

  31. Greven KM, Curran Jr WJ, Whitington R, et al. Analysis of failure patterns in stage III endometrial carcinoma and therapeutic implications. Int J Radiat Oncol Biol Phys. 1989;17:35–9.

    PubMed  CAS  Google Scholar 

  32. Feuer GA, Calanog A. Endometrial carcinoma: treatment of positive paraaortic nodes. Gynecol Oncol. 1987;27:104–9.

    PubMed  CAS  Google Scholar 

  33. Eifel PJ. Can patients with regional metastases from carcinoma of the endometrium be cured with radiation therapy? In: Meyer JL, editor. The lymphatic system and cancer. Basel: Karger; 1994. p. 196–203.

    Google Scholar 

  34. Hicks ML, Piver MS, Puretz JL, et al. Survival in patients with paraaortic lymph node metastases from endometrial adenocarcinoma clinically limited to the uterus. Int J Radiat Oncol Biol Phys. 1993;26:607–11.

    PubMed  CAS  Google Scholar 

  35. Munnell EW, Bonney Jr WA. Critical points of failure in the therapy of cancer of the cervix. Am J Obstet Gynecol. 1961;81:521–32.

    PubMed  CAS  Google Scholar 

  36. Calame RJ. Recurrent carcinoma of the cervix. Am J Obstet Gynecol. 1969;105:380–5.

    PubMed  CAS  Google Scholar 

  37. Brady LW, Perez CA, Bedwinek JM. Failure patterns in gynecologic cancer. Int J Radiat Oncol Biol Phys. 1986;12:549–57.

    PubMed  CAS  Google Scholar 

  38. Thomas GM, Dembo AJ, Black B, et al. Concurrent radiation and chemotherapy for carcinoma of the cervix recurrent after radical surgery. Gynecol Oncol. 1987;27:254–60.

    PubMed  CAS  Google Scholar 

  39. Lawhead Jr RA, Clark DGC, Smith DH, Pierce VK, Lewis Jr JL. Pelvic exenteration for recurrent or persistent gynecologic malignancies: a 10 year review of the Memorial Sloan-Kettering Cancer Center experience. Gynecol Oncol. 1989;33:279–82.

    PubMed  Google Scholar 

  40. Shingleton HM, Soong SJ, Gelder MS, Hatch KD, Baker VV, Austin Jr JM. Clinical and histopathological factors predicting recurrence and survival after pelvic exenteration for cancer of the cervix. Obstet Gynecol. 1989;73:1027–34.

    PubMed  CAS  Google Scholar 

  41. Hatch KD, Shingleton HM, Soong SJ, Baker VV, Gelder MS. Anterior pelvic exenteration. Gynecol Oncol. 1988;31:205–13.

    PubMed  CAS  Google Scholar 

  42. Prasasvinichai S, Glassburn JR, Lewis GC. Treatment of recurrent carcinoma of the cervix. Int J Radiat Oncol Biol Phys. 1978;4:957–61.

    PubMed  CAS  Google Scholar 

  43. Coleman RL, Keeney ED, Freedman RS, Burke TW, Eifel PJ, Rutledge FN. Radical hysterectomy for recurrent carcinoma of the uterine cervix after radiotherapy. Gynecol Oncol. 1994;55:29–35.

    PubMed  CAS  Google Scholar 

  44. Shingleton HM, Gore H, Soong SJ, et al. Tumor recurrence and survival in stage IB cancer of the cervix. Am J Clin Oncol. 1983;6:265–72.

    PubMed  CAS  Google Scholar 

  45. Krebs HB, Helmkamp F, Sevin BU, Poliakiff SR, Nadji M, Averette HE. Recurrent cancer of the cervix following radical hysterectomy and pelvic node dissection. Obstet Gynecol. 1982;59:422–7.

    PubMed  CAS  Google Scholar 

  46. Deutsch M, Parsons JA. Radiotherapy for carcinoma of the cervix recurrent after surgery. Cancer. 1974;34:2051–5.

    PubMed  CAS  Google Scholar 

  47. Jobsen JJ, Leer JWH, Cleton FJ, Hermans J. Treatment of locoregional recurrence of carcinoma of the cervix by radiotherapy after primary surgery. Gynecol Oncol. 1989;33:368–71.

    PubMed  CAS  Google Scholar 

  48. Friedman M, Pearlman AW. Carcinoma of the cervix: radiation salvage of surgical failures. Radiology. 1965;84:801–11.

    PubMed  CAS  Google Scholar 

  49. Potter ME, Alvarez RD, Gay FL, Shingleton HM, Soong SJ, Hatch KD. Optimal therapy for pelvic recurrence after radical hysterectomy for early-stage cervical cancer. Gynecol Oncol. 1990;37:74–7.

    PubMed  CAS  Google Scholar 

  50. Ciatto S, Pirtoli L, Cionini L. Radiotherapy for postoperative failures of carcinoma of the cervix uteri. Surg Gynecol Obstet. 1980;151:621–4.

    PubMed  CAS  Google Scholar 

  51. Tan R, Chung CH, Liu MT, Lai YL, Chang KH. Radiotherapy for postoperative recurrent uterine cervical carcinoma. Acta Oncol. 1991;30:353–6.

    PubMed  CAS  Google Scholar 

  52. Mahe MA, Gerard JP, Dubois JB, et al. Intraoperative radiation therapy in recurrent carcinoma of the uterine cervix: report of the French Intraoperative Group on 70 patients. Int J Radiat Oncol Biol Phys. 1995;34:21–6.

    Google Scholar 

  53. Nori D, Hilaris BS, Kim HS, et al. Interstitial irradiation in recurrent gynecological cancer. Int J Radiat Oncol Biol Phys. 1981;7:1513–7.

    PubMed  CAS  Google Scholar 

  54. Monk BJ, Walker JL, Tewari K, Ramsinghani NS, Syed AMN, DiSaia PJ. Open interstitial brachytherapy for the treatment of local-regional recurrences of uterine corpus and cervix cancer after primary surgery. Gynecol Oncol. 1994;52:222–8.

    PubMed  CAS  Google Scholar 

  55. Alberts DS, Garcia DJ. Salvage chemotherapy in recurrent or refractory squamous cell cancer of the uterine cervix. Semin Oncol. 1994;21:37–46.

    PubMed  CAS  Google Scholar 

  56. Pirtoli L, Ciatto S, Taddei G, Colafrancheschi M. Salvage with radiotherapy of postsurgical relapses of endometrial cancer. Tumori. 1980;66:475–80.

    PubMed  CAS  Google Scholar 

  57. Phillips GL, Prem KA, Adcock LL, Twiggs LB. Vaginal recurrence of adenocarcinoma of the endometrium. Gynecol Oncol. 1982;13:323–8.

    PubMed  CAS  Google Scholar 

  58. Aalders JG, Abeler V, Kolstad P. Recurrent adenocarcinoma of the endometrium: a clinical and histopathological study of 379 patients. Gynecol Oncol. 1984;17:85–103.

    PubMed  CAS  Google Scholar 

  59. Kuten A, Grigsby PW, Perez C, Fineberg B, Garcia DM, Simpson JR. Results of radiotherapy in recurrent endometrial carcinoma: a retrospective analysis of 51 patients. Int J Radiat Oncol Biol Phys. 1989;17:29–34.

    PubMed  CAS  Google Scholar 

  60. Vavra N, Denison U, Kucera H, et al. Prognostic factors related to recurrent endometrial carcinoma following initial surgery. Acta Obstet Gynecol Scand. 1993;72:205–9.

    PubMed  CAS  Google Scholar 

  61. Morgan III JD, Reddy S, Sarin P, Yordan E, DeGeest K, Hendrickson FR. Isolated vaginal recurrences of endometrial carcinoma. Radiology. 1993;189:609–13.

    PubMed  Google Scholar 

  62. Garton GR, Gunderson LL, Webb MJ, et al. Intraoperative radiation therapy in gynecologic cancer: the Mayo Clinic experience. Gynecol Oncol. 1993;48:328–32.

    PubMed  CAS  Google Scholar 

  63. Garton GR, Gunderson LL, Webb MJ, Wilson TO, Cha SS, Podratz KC. Intraoperative radiation therapy in gynecologic cancer: update of the experience at a single institution. Int J Radiat Oncol Biol Phys. 1997;37:839–43.

    PubMed  CAS  Google Scholar 

  64. Sindelar WF, Hoekstra HJ, Kinsella TJ. Surgical approaches and techniques in intraoperative radiotherapy for intra-abdominal, retroperitoneal, and pelvic neoplasms. Surgery. 1988;103:247–56.

    PubMed  CAS  Google Scholar 

  65. Tettersall MHN, Lorvidhaya V, Vootiprux V, et al. Randomized trial of epirubicin and cisplatin chemotherapy followed by pelvic radiation in locally advanced cervical cancer. J Clin Oncol. 1995;13:444–51.

    Google Scholar 

  66. Kumar L, Kaushal R, Nandy M, et al. Chemotherapy followed by radiotherapy versus radiotherapy alone in locally advanced cervical cancer: a randomized study. Gynecol Oncol. 1994;54:307–15.

    PubMed  CAS  Google Scholar 

  67. Souhami L, Gil RA, Allan SE, et al. A randomized trial of chemotherapy followed by pelvic radiation therapy in stage IIIB carcinoma of the cervix. J Clin Oncol. 1991;9:970–7.

    PubMed  CAS  Google Scholar 

  68. Chiara S, Bruzzone M, Merlini L, et al. Randomized study comparing chemotherapy plus radiotherapy versus radiotherapy alone in FIGO stage IIB-III cervical carcinoma. Am J Clin Oncol. 1994;17:294–7.

    PubMed  CAS  Google Scholar 

  69. Tattersall MHN, Ramirez C, Coppleson M. A randomized trial of adjuvant chemotherapy after radical hysterectomy in stage IB-IIA cervical cancer patients with pelvic lymph node metastases. Gynecol Oncol. 1992;46:176–81.

    PubMed  CAS  Google Scholar 

  70. Peters III WA, Liu PY, Barrett RJ, et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol. 2000;18:1606–13.

    PubMed  CAS  Google Scholar 

  71. Mohiuddin M, Lingareddy V, Rakinic J, Marks G. Reirradiation for rectal cancer and surgical resection after ultra high doses. Int J Radiat Oncol Biol Phys. 1993;27:1159–63.

    PubMed  CAS  Google Scholar 

  72. Long III HJ, Cross WG, Wieand HS, et al. Phase II trial of methotrexate, vinblastine, doxorubicin, and cisplatin in advanced/recurrent carcinoma of the uterine cervix and vagina. Gynecol Oncol. 1995;57:235–9.

    PubMed  Google Scholar 

  73. Merrick III HW. Surgical aspects of intraoperative radiation therapy. In: Vaeth JM, Meyer JL, editors. The role of high energy electrons in the treatment of cancer. Basel: Karger; 1991. p. 209–23.

    Google Scholar 

  74. Tepper JE, Gunderson LL, Orlow E, et al. Complications of intraoperative radiation therapy. Int J Radiat Oncol Biol Phys. 1984;10:1831–9.

    PubMed  CAS  Google Scholar 

  75. Avizonis VN, Sause WT, Noyes DR. Morbidity and mortality associated with intraoperative radiotherapy. J Surg Oncol. 1989;41:240–5.

    PubMed  CAS  Google Scholar 

  76. Kinsella TJ, Sindelar WF. Normal tissue tolerance to intraoperative radiation therapy. Experimental and clinical studies. In: Vaeth JM, Meyer JL, editors. Radiation tolerance of normal tissues. Basel: Karger; 1989. p. 202–14.

    Google Scholar 

  77. Haddock MG, Petersen IA, Webb MJ, Wilson TO, Podratz KC, Gunderson LL. Intraoperative radiotherapy for locally advanced gynecological malignancies. Front Radiat Ther Oncol. 1997;31:256–9.

    PubMed  CAS  Google Scholar 

  78. Stelzer KJ, Koh WJ, Greer BE, et al. The use of intraoperative radiation therapy in radical salvage for recurrent cervical cancer: outcome and toxicity. Am J Obstet Gynecol. 1995;172:1881–8.

    PubMed  CAS  Google Scholar 

  79. Stelzer K, Koh W, Greer B, et al. Intraoperative electron beam therapy (IOEBT) as an adjunct to radical salvage for recurrent cancer of the cervix. In: Schildberg FW, Willich N, Kramling HJ, editors. Intraoperative radiation therapy. Essen, Germany: Verlag Die Blaue Eule; 1993. p. 411.

    Google Scholar 

  80. Goldson AL, Delgado G, Hill LT. Intraoperative radiation of the paraaortic nodes in cancer of the uterine cervix. Obstet Gynecol. 1978;52:713–7.

    PubMed  CAS  Google Scholar 

  81. Delgado G, Goldson AL, Ashayeri E, Hill LT, Petrilli ES, Hatch KD. Intraoperative radiation in the treatment of advanced cervical cancer. Obstet Gynecol. 1984;63:246–52.

    PubMed  CAS  Google Scholar 

  82. Yordan EL, Jurado M, Kiel K, et al. Intra-operative radiation therapy in the treatment of pelvic malignancies: a preliminary report. Baillières Clin Obstet Gynaecol. 1988;2:1023–34.

    PubMed  CAS  Google Scholar 

  83. Konski A, Neisler J, Phibbs G, Bronn D, Dobelbower Jr RR. The use of intraoperative electron beam radiation therapy in the treatment of para-aortic metastases from gynecologic tumors: a pilot study. Am J Clin Oncol. 1993;16:67–71.

    PubMed  CAS  Google Scholar 

  84. Dosoretz DE, Tepper JE, Shim DS, et al. Intraoperative electron-beam irradiation in gynecologic malignant disease. Appl Radiol. 1984;13:61–3.

    Google Scholar 

  85. Haddock MG, Martinez-Monge R, Petersen IA, Wilson TO. Locally advanced primary and recurrent gynecologic malignancies: EBRT with or without IOERT or HDR-IORT. In: Gunderson LL, Willett CG, Harrison LB, Calvo FC, editors. Intraoperative irradiation: techniques and results. Totowa NJ: Humana Press; 1999. p. 397–420.

    Google Scholar 

  86. Garton GR, Gunderson LL, Webb MJ, et al. Intraoperative irradiation in gynecologic cancer: the Mayo Clinic experience. Gynacol Oncol. 1993;48:328–32.

    CAS  Google Scholar 

  87. Haddock MG, Petersen IA, Webb MJ, et al. Intraoperative radiation therapy for locally advanced gynecological malignancies. ISIORT 2002 Proceedings, Abstract 5.5, Aachen.

    Google Scholar 

  88. Haddock MG. Intraoperative radiation therapy for locally advanced gynecologic malignancies. ISIORT 2005; personal communication.

    Google Scholar 

  89. Dowdy SC, Mariani A, Cliby WA, Haddock MG, Petersen IA, Sim FH, et al. Radical pelvic resection and intraoperative radiation therapy for recurrent endometrial cancer: technique and analysis of outcomes. Gynecol Oncol. 2006;101:280–6.

    PubMed  Google Scholar 

  90. Martinez-Monge, R. IORT in the management of locally advanced or recurrent gynecologic cancer at high risk for loco-regional relapse. Doctoral Thesis. Spain: University of Navarre; 1994.

    Google Scholar 

  91. Gerard JP, Dargent D, Raudrant D, et al. Place de la radiotherapie peroperatoire dans le traitement des cancer de l’uterus. Experience lyonnaise preliminaire. Bull Cancer/Radiother. 1994;81:186–95.

    CAS  Google Scholar 

  92. Martinez-Monge R, Jurado M, Aristu JJ, et al. Intraoperative electron beam radiotherapy during radical surgery for locally advanced and recurrent cervical cancer. Gynecol Oncol. 2001;82:538–43.

    PubMed  CAS  Google Scholar 

  93. Hicks ML, Piver S, Mas E, Hempling RE, McAuley M, Walsh DL. Intraoperative orthovoltage radiation therapy in the treatment of recurrent gynecologic malignancies. Am J Clin Oncol. 1993;16:497–500.

    PubMed  CAS  Google Scholar 

  94. Tran PT, Kapp D, et al. Long-term survivors using intraoperative radiotherapy for recurrent gynecologic malignancies. Int J Radiat Oncol Biol Phys. 2007;69:504–11.

    PubMed  Google Scholar 

  95. Hockel M, Knapstein PG. The combined operative and radiotherpeutic treatment (CORT) of recurrent tumors infiltrating the pelvic wall: first experience with 18 patients. Gynecol Oncol. 1992;46:20–8.

    PubMed  CAS  Google Scholar 

  96. Gemignani ML, Alektiar KM, Leitao M, et al. Radical surgical resection and high-dose intraoperative radiation therapy (HDR-IORT) in patients with recurrent gynecologic cancers. Int J Radiat Oncol Biol Phys. 2001;50:687–94.

    PubMed  CAS  Google Scholar 

  97. Aubey JJ, McCreath W, Chi DS, Alektiar K, et al. Outcomes of patients with recurrent gynecologic malignancies treated with radical surgical resection and high dose rate intraoperative therapy (HDR-IORT). The 35th Annual SGO meeting in San Diego, CA; 2004.

    Google Scholar 

  98. Caceres A, Mourton SM, Bochner BH, Gerst SR, Liu L, Alektiar KM, et al. Extended pelvic resections for recurrent uterine and cervical cancer: out-of-the-box surgery. Int J Gynecol Cancer. 2008;18(5):1139–44.

    PubMed  CAS  Google Scholar 

  99. Konski AA, Neisler J, Phibbs G, Brown DG, Dobelbower Jr RR. A pilot study investigating intraoperative electron beam irradiation in the treatment of ovarian malignancies. Gynecol Oncol. 1990;38:121–4.

    PubMed  CAS  Google Scholar 

  100. Yap OW, Kapp D, et al. Intraoperative radiation therapy in recurrent ovarian cancer. Int J Radiat Oncol Biol Phys. 2005;63:1114–21.

    PubMed  Google Scholar 

  101. Moore DH, Blessing JA, McQuellon RP, Thaler HT, Cella D, Benda J, et al. Phase III study of cisplatin with or without paclitaxel in Stage IVB, recurrent, or persistent squamous cell carcinoma of the cervix: a Gynecologic Oncology Group Study. J Clin Oncol. 2004;22:3113–9.

    PubMed  CAS  Google Scholar 

  102. Long III HJ, Bundy BN, Grendys Jr EC, Benda JA, McMeekin DS, Sorosky J, et al. Randomized phase III trial of cisplatin with or without topotecan in carcinoma of the uterine cervix: a Gynecologic Oncology Group Study. J Clin Oncol. 2005;23:4626–33.

    PubMed  CAS  Google Scholar 

  103. Thigpen JT, Brady MF, Homesley HD, et al. Phase III trial of doxorubicin with or without cisplatin in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2004;22:3902–8.

    PubMed  CAS  Google Scholar 

  104. Fleming GF, Filiaci VL, Bentley RC, et al. Phase III randomized trial of doxorubicin  +  cisplatin versus doxorubicin  +  24-h paclitaxel  +  filgrastim in endometrial carcinoma: a Gynecologic Oncology Group study. Ann Oncol. 2004;15:1173–8.

    PubMed  CAS  Google Scholar 

  105. Fleming GF, Brunetto VL, Cella D, et al. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2004;22:2159–66.

    PubMed  CAS  Google Scholar 

  106. Barber HRK, O’Neil WH. Recurrent cervical cancer after treatment by a primary surgical program. Obstet Gynecol. 1971;37:165–72.

    PubMed  CAS  Google Scholar 

  107. Gunderson LL, Nelson H, Martenson JA, et al. Intraoperative electron and external beam irradiation with or without 5-fluorouracil and maximum surgical resection for previously unirradiated locally recurrent colorectal cancer. Dis Colon Rectum. 1996;39:1379–95.

    PubMed  CAS  Google Scholar 

  108. Fyles AW, Pintilie M, Kirkbride P, Levin W, Manchul LA, Rawlings GA. Prognostic factors in patients with cervix cancer treated by radiation therapy: results of a multiple regression analysis. Green. 1995;35:107–17.

    CAS  Google Scholar 

  109. Komaki R, Brickner TJ, Hanlon AL, Owen JB, Hanks GE. Long-term results of treatment of cervical carcinoma in the United States in 1973, 1978, and 1983: Patterns of Care Study (PCS). Int J Radiat Oncol Biol Phys. 1995;31:973–82.

    PubMed  CAS  Google Scholar 

  110. Petereit DG, Sarkaria JN, Chappell R, et al. The adverse effect of treatment prolongation in cervical carcinoma. Int J Radiat Oncol Biol Phys. 1995;32:1301–7.

    PubMed  CAS  Google Scholar 

  111. Teshima T, Inoue T, Ikeda H, et al. High-dose rate and low-dose rate intracavitary therapy for carcinoma of the uterine cervix. Cancer. 1993;72:2409–14.

    PubMed  CAS  Google Scholar 

  112. Mitsuhashi N, Takahashi M, Nozaki M, et al. Evaluation of external beam therapy and three brachytherapy fractions for carcinoma of the uterine cervix. Int J Radiat Oncol Biol Phys. 1994;29:975–82.

    PubMed  CAS  Google Scholar 

  113. Ito H, Kutuki S, Nishiguchi I, et al. Radiotherapy for cervical cancer with high-dose rate brachytherapy correlation between tumor size, dose and failure. Green. 1994;31:240–7.

    CAS  Google Scholar 

  114. Patel FD, Sharma SC, Negi PS, Ghoshal S, Gupta BD. Low dose rate vs. high dose rate brachytherapy in the treatment of carcinoma of the uterine cervix: a clinical trial. Int J Radiat Oncol Biol Phys. 1993;28:335–41.

    Google Scholar 

  115. Montana GS, Fowler WC, Varia MA, Walton LA, Mack Y, Shemanski L. Carcinoma of the cervix, stage III: results of radiation therapy. Cancer. 1986;57:148–54.

    PubMed  CAS  Google Scholar 

  116. Jones WB, Shingleton HM, Russell A, et al. Patterns of care for invasive cervical cancer: results of a national survey of 1984 and 1990. Cancer. 1995;76:1934–47.

    PubMed  CAS  Google Scholar 

  117. Horiot JC, Pigneux J, Pourquier H, et al. Radiotherapy alone in carcinoma of the intact uterine cervix according to G. H. Fletcher guidelines: a French cooperative study of 1383 cases. Int J Radiat Oncol Biol Phys. 1988;14:605–11.

    PubMed  CAS  Google Scholar 

  118. Brunet J, Alonso C, Llanos M, et al. Chemotherapy and radiotherapy in locally advanced cervical cancer. Acta Oncol. 1995;34(7):941–4.

    PubMed  CAS  Google Scholar 

  119. Benedett-Pacini P, Maneschi F, Cutillo G, et al. Modified type IV-V radical hysterectomy with systematic pelvic and aortic lymphadenectomy in the treatment of patients with stage III cervical carcinoma. Cancer. 1996;78:2359–65.

    Google Scholar 

  120. Pas E, Willemse PHB, Boonstra H, et al. Concurrent chemo- and radiotherapy in patients with locally advanced carcinoma of the cervix. Ann Oncol. 1996;7:511–6.

    Google Scholar 

  121. Fields AL, Anderson PS, Goldberg GL, et al. Mature results of a phase II trial of concomitant Cisplatin/pelvic radiotherapy for locally advanced squamous cell carcinoma of the cervix. Gynecol Oncol. 1996;61:416–22.

    PubMed  CAS  Google Scholar 

  122. Stehman FB, Bundy BN, Thomas G, et al. Hydroxyurea versus misonidazole with radiation in cervical carcinoma: long-term follow-up of a Gynecologic Oncology Group trial. J Clin Oncol. 1993;11:1523–8.

    PubMed  CAS  Google Scholar 

  123. Thomas G, Dembo A, Fyles A, et al. Concurrent chemoradiation in advanced cervical cancer. Gynecol Oncol. 1990;38:446–51.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA

    Kaled M. Alektiar

  2. Department of Radiation Oncology, Mayo Clinic Cancer Center, 200 First Street SW, Rochester, MN, 55905, USA

    Michael G. Haddock & Ivy A. Petersen

  3. Department of Oncology, Hospital Gregorio Maranón, Dr. Esquerdo 46, Madrid, 28007, Spain

    Felipe A. Calvo

  4. Department of Gynecologic Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA

    Dennis Chi

Authors
  1. Kaled M. Alektiar
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  2. Michael G. Haddock
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  3. Dennis Chi
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  4. Felipe A. Calvo
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  5. Ivy A. Petersen
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Correspondence to Kaled M. Alektiar .

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Editors and Affiliations

  1. Department of Radiation Oncology, Mayo Clinic, East Shea Blvd 13400, Scottsdale, 85259, Arizona, USA

    Leonard L. Gunderson

  2. Dept. Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA

    Christopher G. Willett

  3. Gregorio Marañón, Depto. Radiación de Oncología, Hospital General Universitario, C/ Dr. Esquerdo 46, Madrid, 28007, Spain

    Felipe A. Calvo

  4. Albert Einstein College of Medicine, Radiation Oncology, Beth Israel Medical Center, Union Square East 10, New York, 10003, New York, USA

    Louis B. Harrison

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Alektiar, K.M., Haddock, M.G., Chi, D., Calvo, F.A., Petersen, I.A. (2011). Gynecologic Malignancies. In: Gunderson, L., Willett, C., Calvo, F., Harrison, L. (eds) Intraoperative Irradiation. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-61779-015-7_20

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