title: Stereotactic radiotherapy in recurrent gynecological cancer: a case series.
abstract: Scarce data are available on the use of extracranial stereotactic radiotherapy in recurrent gynecological tumors. The aim of this report was to analyze the results of our preliminary experience with extracranial stereotactic radiotherapy in locally or distantly recurrent gynecological tumors. Extracranial stereotactic radiotherapy was planned by the Precise-Plan treatment planning system. Patients were immobilized using the Stereotactic Body-Frame. Five consecutive daily fractions were delivered; dose/fraction and total dose were defined based on an institutional dose-escalation protocol. A class solution with 4 non-coplanar fixed beams based on the tetrad configuration was used in all patients. Eleven patients (12 lesions), were included in the analysis. Stereotactic radiotherapy was delivered as first radiotherapy treatment (5 patients), or as retreatment (6 patients). Complete clinical response was achieved in 8/12 lesions (66.6%), while partial response was documented in 2/12 lesions (16.6%). With a median follow-up of 19 months (range, 2-37 months), 7 patients (63%) experienced local and/or distant progression of disease. The 2-year local progression-free survival was 81.8%, while the 2-year metastases-free survival was 54.4%. The 2-year overall survival was 63.6%. Acute and late toxicities were grade 2 or less. There was no difference in quality of life scores between the data collected before extracranial stereotactic radiotherapy and at first follow-up evaluation. Fractionated extracranial stereotactic radiotherapy administered up to a dose of 30 Gy in five fractions is well tolerated. Further studies of extracranial stereotactic radiotherapy and novel radiotherapy techniques are warranted in the challenging setting of recurrent gynecological tumors.
authors: John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, I-86100 Campobasso, Rome, Italy.
authors: Francesco
authors: F
authors: Deodato
authors: Gabriella
authors: G
authors: Macchia
authors: Luca
authors: L
authors: Grimaldi
authors: Gabriella
authors: G
authors: Ferrandina
authors: Domenica
authors: D
authors: Lorusso
authors: Vanda
authors: V
authors: Salutari
authors: Savino
authors: S
authors: Cilla
authors: Vincenzo
authors: V
authors: Valentini
authors: Numa
authors: N
authors: Cellini
authors: Angelo
authors: A
authors: Piermattei
authors: Giovanni
authors: G
authors: Scambia
authors: Alessio Giuseppe
authors: AG
authors: Morganti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D016634:Radiosurgery