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Gynecological Malignancies

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Re-Irradiation: New Frontiers

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

Surgical, technical, and biological advancements in treatment have improved clinical outcomes for patients with gynecological malignancies. Despite this a significant proportion will relapse locally, requiring multidisciplinary management. Patients who received definitive radiotherapy as primary treatment are ideally treated with surgery; however, this is not always possible. Re-irradiation poses a therapeutic dilemma, as the desire for local control must be weighed against the potential risks associated with re-treatment. A patient’s suitability for radical re-treatment is determined by multiple factors: clinical performance status, symptomatology, site of recurrence, previous radiotherapy delivery technique, dose/fractionation, radiation-related toxicities, and disease extent. With improvement in technologies, an aggressive approach is now feasible and worth pursuing in carefully selected patients, where not only palliation of local symptoms is possible but also long-term local control. In this review, the clinical, tumor, and radiobiological factors as well as technological considerations are highlighted. A treatment algorithm for patients presenting for consideration of re-irradiation for recurrent gynecological malignancy is also presented.

The original version of this chapter was revised. An erratum to this chapter can be found at 10.1007/978-3-319-41825-4_78.

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Authors and Affiliations

  1. Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Jennifer Croke & Anthony Fyles

  2. Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada

    Jennifer Croke, Eric Leung & Anthony Fyles

  3. Department of Radiation Oncology, Odette Cancer Center, Toronto, ON, Canada

    Eric Leung

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  1. Jennifer Croke
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  2. Eric Leung
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Correspondence to Anthony Fyles .

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Editors and Affiliations

  1. Department of Oncology, University of Tromso and Nordland Hospital, Bodo, Norway

    Carsten Nieder

  2. University Medical Center Groningen, Groningen, The Netherlands

    Johannes Langendijk

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Croke, J., Leung, E., Fyles, A. (2016). Gynecological Malignancies. In: Nieder, C., Langendijk, J. (eds) Re-Irradiation: New Frontiers. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2016_47

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  • DOI: https://doi.org/10.1007/174_2016_47

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  • Print ISBN: 978-3-319-41823-0

  • Online ISBN: 978-3-319-41825-4

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