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Updated: Mar 16, 2026
Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
Particle Beam Re-irradiation in Oligo Recurrent Gynecological Malignancies
A Barcellini1, A Vai2, G Fontana3
1Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy; Radiation Oncology Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, Pavia, Italy.
Objective:
This study aimed to evaluate the efficacy and safety of proton beam radiotherapy (PBRT) and carbon ion radiotherapy (CIRT) as salvage treatments for oligorecurrent gynecological cancers.
Materials And Methods:
A retrospective analysis was performed on consecutive patients treated with PBRT or CIRT for recurrent gynecological tumors. The primary endpoints included the objective response rate (ORR) as well as 1- and 2-year local control (LC) survival rates. Toxicity was assessed as a secondary endpoint and graded according to the Common Terminology Criteria for Adverse Events (CTCAE) 5.0 scale. Actuarial outcomes were evaluated using the Kaplan-Meier method, and predictors were identified with the Log-rank test.
Results:
A total of 27 patients (median age: 64.5 years; IQR = 56.0, 69.0) with 28 recurrent lesions were treated with either PBRT (N = 12) or CIRT (N = 16), without concurrent systemic therapies. The majority of patients were treated for recurrences of cervical cancer (N = 8, 29%), endometrial cancer (N = 7, 25%), and ovarian cancer (N = 6, 21%). The most frequent site of recurrence was lymph nodes (N = 14, 50%). Lesions treated with CIRT had a larger volume (median volume 118 [IQR = 66, 233.5] vs. 99 [IQR = 54, 152.3]) and lower alpha/beta ratios (median = 3.8 [IQR = 3.5, 4.5] vs. 7.3 [IQR = 3.5, 10.0]). The overall ORR was 68% within 6 months and did not significantly vary between the groups (p = 0.687). The 1- and 2-year LC rates were 100% and 100% for PBRT, compared to 83% and 62% for CIRT (p = 0.075). Larger lesion volumes (p = 0.035) and failure to achieve an ORR (p = 0.009) were associated with worse LC outcomes, while lymph node recurrences (p = 0.052) and lower alpha/beta ratios (p = 0.078) were potentially linked to better LC. Both treatments were well tolerated, with no grade ≥3 toxicities observed.
Conclusions:
PBRT and/or CIRT appeared as an effective and safe option for recurrent gynecological cancers in a real-world setting. Larger cohorts and longer follow-up are needed for further validation and refining patient selection.
