Radiation in gynecology

Radiation in gynecology د. سها وتوت

Gynecological cancer were among the malignant tumors treated with ionizing radiation.

Today, radiation therapy remain an essential component for both primary non surgical management & the adjuvant post operative treatment of selected malignancies arising in the female reproductive tract.

Current strategies for treating cancer of the uterine corpus, uterine cervix ,vulva &vagina are tailored to the clinical& pathological stage of the disease.

Early- stage lesions can be treated surgically. Postoperative radiotherapy is reserved for cases in which histopathological analysis of the removed specimen revealed features suggesting high risk of recurrence.

Primary radiotherapy can provide cure for women with unresectable locally advanced disease, for women unfit for surgery or surgical resection associated with high morbidity.

Palliative radiotherapy usually improve quality of life, relieve symptoms & this is usually for un respectable tumors.

Carcinoma of the uterine corpus:

Clinical features & staging return back to endometrial cancer

Indication of radiotherapy
1. when hysterectomy is medically contraindicated. primary radiotherapy can offer 5-years disease specific survival rate of 80-90%.
2.adjuvant radiotherapy after surgery :whole pelvic radiotherapy( external beam radiotherapy EBR ) & intravaginal brachytherapy are potential adjuvant postoperative therapy for stage 1 disease.
The use of intravaginal brachytherapy in stage IIB grade 1 &2 significantly reduce the incidence of vaginal recurrence to less than 1%.
3.for stage II endometrial carcinoma , pre & postoperative radiotherapy may be administered.
4. For stage III-IV, there may be combination of pelvic EBR, whole abdominal radiotherapy, intravaginal brachytherapy & chemotherapy.