Radiation therapy for the gynecologic oncologist

Radiation therapy for the gynecologic oncology patient has evolved in the last century but continues to be an integral component of care for women with pelvic malignancies. This review discusses the essential aspects of physics, radiobiology, and imaging for radiation therapy. It aims to review the increasing indications for radiation therapy in gynecologic neoplasms such as for oligometastatic disease and palliative measures. It also discusses the widespread adoption of IMRT, increasing use of SBRT and proton beam therapy, and modernization of brachytherapy in gynecological cancer, while also touching on the interdigitation of immunotherapy, as well as the impact of molecular factors in adjuvant endometrial cancer treatment. Radiation oncology, like other oncologic disciplines, continues to evolve to provide less morbidity with improved outcomes and experience for our patients. And thus, the following review discusses innovations in radiotherapy used in gynecologic malignancies today and the advances we see impacting the field of gynecologic oncology moving forward.