title: Whole pelvic intensity-modulated radiotherapy for gynecological malignancies: A review of the literature.
abstract: Radiation therapy has long played a major role in the treatment of gynecological malignancies. There is increasing interest in the utility of intensity-modulated radiotherapy (IMRT) and its application to treat gynecological malignancies. Herein, we review the state-of-the-art use of IMRT for gynecological malignancies and report how it is being used alone as well as in combination with chemotherapy in both the adjuvant and definitive settings. Based on dosimetric and clinical evidence, IMRT can reduce gastrointestinal, genitourinary, and hematological toxicities compared with 3D-conformal radiotherapy for gynecologic malignancies. We discuss how these attributes of IMRT may lead to improvements in disease outcomes by allowing for dose escalation of radiation therapy, intensification of chemotherapy, and limiting toxicity-related treatment breaks. Currently accruing trials investigating pelvic IMRT for cervical and endometrial cancers are discussed.
authors.affiliation: Louisiana State University Health Sciences Center, School of Medicine, 1901 Perdido Street, New Orleans, LA 70112, United States. Electronic address: rhyme1@lsuhsc.edu.
authors.forename: Rockne
authors.initials: R
authors.lastname: Hymel
authors.affiliation: Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, United States. Electronic address: guy.jones@nih.gov.
authors.forename: Guy C
authors.initials: GC
authors.lastname: Jones
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States. Electronic address: charles.simone@uphs.upenn.edu.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Simone
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D010388:Pelvis / Q000473:pathology* / Q000528:radiation effects*; D011874:Radiometry; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
keywords: Cervical; Endometrial; Gynecologic; IMRT; Radiation therapy