Stereotactic Body Radiation Therapy in Gynecologic Oligometastases: An Effective but Underutilized Approach

Area of Science:

• Gynecologic Oncology
• Radiation Oncology
• Medical Physics

Background:

• Historically, radiation therapy for gynecologic metastatic disease focused on palliation.
• Stereotactic Body Radiation Therapy (SBRT) has demonstrated survival benefits in oligometastatic disease across various primary cancers.
• Gynecologic oligometastases have been underrepresented in clinical trials evaluating SBRT.

Purpose of the Study:

• To review the current literature on SBRT for recurrent or oligometastatic gynecologic cancer (ROMGC).
• To analyze the advantages and drawbacks of SBRT in this patient population.
• To guide patient-centered treatment decisions for ROMGC.

Main Methods:

• Literature review of studies investigating SBRT for gynecologic malignancies.
• Analysis of outcomes, including survival benefits and toxicity profiles.
• Examination of existing data to inform clinical practice.

Main Results:

• Recent studies indicate favorable outcomes and acceptable toxicities for SBRT in ROMGC patients.
• SBRT is particularly effective in ovarian cancer, especially for chemo-resistant disease.
• The largest body of literature supports SBRT's efficacy in ovarian oligometastases.

Conclusions:

• SBRT is an effective treatment option for ROMGC, offering survival benefits and manageable toxicity.
• Despite encouraging outcomes, SBRT is underutilized due to a lack of long-term, randomized studies.
• Further prospective trials are necessary to establish SBRT as the standard of care for ROMGC.