Intraoperative Radiation Therapy for Gynecologic Malignancies: When Is It Indicated?

Area of Science:

• Oncology
• Radiation Oncology
• Gynecologic Oncology

Background:

• Intraoperative radiation therapy (IORT) involves delivering a single high dose of radiation during surgery.
• IORT targets a limited tissue volume, offering a focused treatment approach.
• Its application in gynecologic malignancies requires further outcome assessment.

Purpose of the Study:

• To evaluate treatment outcomes for patients with gynecologic cancers receiving IORT.
• To identify predictive factors for favorable outcomes in this patient cohort.
• To assess the role of IORT in primary or recurrent gynecologic malignancies.

Main Methods:

• Retrospective single-center cohort study.
• Inclusion of patients treated with surgery and IORT for gynecologic cancer (2014-2022).
• Analysis of patient demographics, cancer types, ECOG status, surgical margins, complications, and survival rates.

Main Results:

• 30 patients with gynecologic malignancies (cervical, sarcoma, endometrial, ovarian carcinosarcoma) were treated.
• 70% had an ECOG performance status of 0; no survival difference based on surgical resection margins (R1/2 vs. R0).
• Three-year disease-free survival (DFS) was 53.3%, and five-year overall survival (OS) was 53.3%. ECOG status significantly impacted DFS (p=0.002) and OS (p=0.02).

Conclusions:

• Surgery combined with IORT is a viable treatment option for selected patients with recurrent or locally advanced cervical or endometrial cancer.
• An ECOG performance status of 0 is a significant predictor of positive outcomes.
• ECOG status should be a key consideration in treatment decisions for IORT in gynecologic oncology.