Abstract：
OBJECTIVE: The use of stereotactic body radiation therapy (SBRT) for gynecologic malignancies is controversial. We discuss certain circumstances when highly precise SBRT may be a useful tool to consider in the management of selected patients.
METHODS: Case selection included the following scenarios, the first 2 with palliative intent, para-aortic nodal oligorecurrence of ovarian cancer, pelvic sidewall oligorecurrence of cervical cancer, and inoperable endometrial cancer boost after intensity modulated radiation to the pelvis treated with curative intent. Patient characteristics, fractionation, prescription dose, treatment technique, and dose constraints were discussed. Relevant literature to these cases was summarized to provide a framework for treatment of similar patients.
RESULTS: Treatment of gynecologic malignancies with SBRT requires many considerations, including treatment intent, optimal patient selection, fractionation selection, tumor localization, and plan optimization. Although other treatment paradigms including conventionally fractionated radiation therapy and brachytherapy remain the standard-of-care for definitive treatment of gynecologic malignancies, SBRT may have a role in palliative cases or those where high doses are not required due to the unacceptable toxicity that may occur with SBRT.
CONCLUSIONS: A case-based practice review was developed by the Radiosurgery Society to provide a practical guide to the common scenarios noted above affecting patients with gynecologic malignancies.
METHODS: Case selection included the following scenarios, the first 2 with palliative intent, para-aortic nodal oligorecurrence of ovarian cancer, pelvic sidewall oligorecurrence of cervical cancer, and inoperable endometrial cancer boost after intensity modulated radiation to the pelvis treated with curative intent. Patient characteristics, fractionation, prescription dose, treatment technique, and dose constraints were discussed. Relevant literature to these cases was summarized to provide a framework for treatment of similar patients.
RESULTS: Treatment of gynecologic malignancies with SBRT requires many considerations, including treatment intent, optimal patient selection, fractionation selection, tumor localization, and plan optimization. Although other treatment paradigms including conventionally fractionated radiation therapy and brachytherapy remain the standard-of-care for definitive treatment of gynecologic malignancies, SBRT may have a role in palliative cases or those where high doses are not required due to the unacceptable toxicity that may occur with SBRT.
CONCLUSIONS: A case-based practice review was developed by the Radiosurgery Society to provide a practical guide to the common scenarios noted above affecting patients with gynecologic malignancies.
摘要：
目的：立体定向放疗（SBRT）在妇科恶性肿瘤中的应用存在争议。我们讨论了某些情况下，高度精确的SBRT可能是在选定患者的管理中需要考虑的有用工具。
方法：病例选择包括以下方案，前两个有姑息的意图，卵巢癌的主动脉旁淋巴结低复发，子宫颈癌的盆腔侧壁少复发，和不可手术的子宫内膜癌增加后的强度调制辐射到骨盆治疗的目的。患者特征,分馏,处方剂量,治疗技术,和剂量限制进行了讨论。总结了这些病例的相关文献，为类似患者的治疗提供了框架。
结果：用SBRT治疗妇科恶性肿瘤需要很多考虑因素，包括治疗意图，最佳患者选择，分馏选择，肿瘤定位，和计划优化。虽然其他治疗模式，包括常规分割放射治疗和近距离放射治疗仍然是妇科恶性肿瘤明确治疗的标准治疗方法，SBRT可能在姑息性病例或由于SBRT可能发生的不可接受的毒性而不需要高剂量的病例中起作用。
结论：放射外科学会制定了一项基于案例的实践综述，为上述影响妇科恶性肿瘤患者的常见情况提供了实用指南。
方法：病例选择包括以下方案，前两个有姑息的意图，卵巢癌的主动脉旁淋巴结低复发，子宫颈癌的盆腔侧壁少复发，和不可手术的子宫内膜癌增加后的强度调制辐射到骨盆治疗的目的。患者特征,分馏,处方剂量,治疗技术,和剂量限制进行了讨论。总结了这些病例的相关文献，为类似患者的治疗提供了框架。
结果：用SBRT治疗妇科恶性肿瘤需要很多考虑因素，包括治疗意图，最佳患者选择，分馏选择，肿瘤定位，和计划优化。虽然其他治疗模式，包括常规分割放射治疗和近距离放射治疗仍然是妇科恶性肿瘤明确治疗的标准治疗方法，SBRT可能在姑息性病例或由于SBRT可能发生的不可接受的毒性而不需要高剂量的病例中起作用。
结论：放射外科学会制定了一项基于案例的实践综述，为上述影响妇科恶性肿瘤患者的常见情况提供了实用指南。
