The role of the radiation oncologist in the management of gynecologic cancer

Abstract

Optimal management of patients with gynecologic malignancies requires a multidisciplinary approach with close cooperation between the primary care physician, the gynecologic oncologist and the radiation therapist. In order to obtain maximum survival rates with minimal morbidity, treatment should be based on a detailed knowledge of tumor localization, potential sites of occult spread, and tumor–host interactions. A careful delineation of patterns of recurrence will permit the identification of patients at increased risk for treatment failure and will aid in the design of alternative treatment protocols tailor‐made to control potential site(s) of tumor spread. The technological advances in radiation oncology and their influence on survival rates are presented, with illustrations taken from the literature and from the recent results of the Patterns of Care Study for treatment of carcinoma of the cervix. The role of radiation therapy in the treatment of carcinomas of the cervix, uterus, and the epithelial tumors of the ovary are reviewed, emphasizing treatment protocols based on consideration of technical, tumor, and host factors. Ongoing clinical research trials and potential areas for further improvement in the management of gynecologic malignancies are discussed.

Site and disease selection for hyperthermia clinical trials

“…In some countries in Africa and South America cervical cancer is the largest c a u x of cancer deaths in females. Little improvement has been noted in the treatment rcsults for advanced stage cervix cancer over the past 20 years (Kapp 1983). A high pcrccntage of patients with advanced cervical cancer fail within the pelvis alone, following full dose radiation therapy (Kademian and Bosch 1977).…”