Salvage Curative-Intent Reirradiation Stereotactic Body Radiation Therapy for Isolated Pelvic and/or Paraortic Recurrences of Gynecologic Malignancies

摘要: Abstract Purpose To determine the feasibility of stereotactic body radiation therapy (SBRT) for isolated nodal recurrences gynecologic malignancies within a previously irradiated area. Methods and Materials A retrospective review was performed on 20 patients who underwent 21 curative-intent reirradiation SBRT treatments locoregional malignancies. Disease control survival outcomes were analyzed with Kaplan-Meier method log-rank test. Treatment toxicities graded according to Common Terminology Criteria Adverse Events version 4.03. Results All had an pelvic, paraortic, or intra-abdominal recurrence, exception 1 patient concurrent paraortic right acetabulum metastasis, both which SBRT. Primary sites included cervix (30.0%), uterus (55.0%), vulva (5.0%), vagina ovary (5.0%). Median prior external beam dose 45 Gy. Recurrences in field 14 (66.7%) marginal 7 (33.3%). directed pelvis 13 cases (61.9%) celiac nodes 8 (38.1%). The most common regimen 40 45 Gy 5 fractions (n = 12). At median follow-up 31.2 months, 3-year actuarial in-field local control, distant progression-free survival, overall 61.4%, 44.0%, 51.9%, respectively. time last follow-up, 9 (45.0%) remained alive without evidence disease. Actuarial risk grade ≥2 ≥3 late 38.1% 14.3%, Conclusions pelvic is feasible acceptable toxicity rate. With this approach, about half achieved durable disease-free survival.