title: Stereotactic body radiotherapy for local boost irradiation in unfavourable locally recurrent gynaecological cancer.
abstract: OBJECTIVE
  To evaluate outcome of radiotherapy for locally recurrent cervical and endometrial cancer.
  
  
  METHODS
  Nineteen patients were treated for a locally recurrent cervical (n=12) or endometrial (n=7) cancer median 26 months after initial surgery (n=18) or radiotherapy (n=1). The whole pelvis was irradiated with 50Gy conventionally fractionated radiotherapy (n=16). Because of large size of the recurrent cancer (median 4.5 cm) and peripheral location (n=12), stereotactic body radiotherapy (SBRT; median 3 fractions of 5Gy to 65%) was used for local dose escalation instead of (n=16) or combined with (n=3) vaginal brachytherapy.
  
  
  RESULTS
  After median follow-up of 22 months, 3-year overall survival was 34% with systemic progression the leading cause of death (7/10). Median time to systemic progression was 16 months. Three local recurrences resulted in a local control rate of 81% at 3 years. No correlation between survival, systemic or local control and any patient or treatment characteristic was observed. The rate of late toxicity>grade II was 25% at 3 years: two patients developed a grade IV intestino-vaginal fistula and one patient suffered from a grade IV small bowel ileus.
  
  
  CONCLUSIONS
  Image-guided SBRT for local dose escalation resulted in high rates of local control but was associated with significant late toxicity.
authors.affiliation: Department of Radiation Oncology, Julius-Maximilians University, Wuerzburg, Germany. guckenberger_m@klinik.uni-wuerzburg.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Guckenberger
authors.forename: Johanna
authors.initials: J
authors.lastname: Bachmann
authors.forename: Joern
authors.initials: J
authors.lastname: Wulf
authors.forename: Gerd
authors.initials: G
authors.lastname: Mueller
authors.forename: Thomas
authors.initials: T
authors.lastname: Krieger
authors.forename: Kurt
authors.initials: K
authors.lastname: Baier
authors.forename: Anne
authors.initials: A
authors.lastname: Richter
authors.forename: Juergen
authors.initials: J
authors.lastname: Wilbert
authors.forename: Michael
authors.initials: M
authors.lastname: Flentje
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016634:Radiosurgery; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000601:surgery*