Long-term survivors using intraoperative radiotherapy for recurrent gynecologic malignancies

Area of Science:

• Gynecologic Oncology
• Radiation Oncology
• Surgical Oncology

Background:

• Recurrent or persistent gynecologic malignancies present a significant treatment challenge with poor survival rates.
• Surgery followed by intraoperative radiotherapy (IORT) is a therapeutic option for selected patients.
• Understanding prognostic factors is crucial for optimizing outcomes in this patient population.

Purpose of the Study:

• To analyze treatment outcomes, including locoregional control (LRC), distant metastasis-free survival (DMFS), and disease-specific survival (DSS), in patients with gynecologic malignancies treated with surgery and IORT.
• To identify prognostic factors influencing survival and complications in this cohort.

Main Methods:

• Retrospective review of 36 patients with gynecologic malignancies treated with surgery and IORT.
• Analysis of patient demographics, tumor characteristics, treatment details (including IORT dose and surgical procedures), and follow-up data.
• Kaplan-Meier survival analysis and multivariate analysis to determine prognostic factors and outcomes.

Main Results:

• Five-year LRC, DMFS, and DSS rates for the entire cohort were 44%, 51%, and 47%, respectively.
• Significant prognostic factors identified included disease-free interval for LRC, tumor size for DMFS, and cervical primary, previous surgery, and locoregional relapse for DSS.
• The 5-year complication-free survival rate for Grade 3-4 complications was 72%.

Conclusions:

• Surgery followed by IORT can achieve long-term local control in carefully selected patients with recurrent or persistent gynecologic cancers.
• Prognostic factors such as disease-free interval, tumor size, and specific disease characteristics significantly impact patient outcomes.
• While effective, IORT requires careful patient selection to mitigate treatment-related complications.