Advances in the management of gynecologic cancer--radiation therapy

Much progress has been made in the utilization of radiation therapy techniques in the management of gynecologic malignancies. However, new techniques will continue to emerge for the management of these disease processes. At this time, high LET radiation is particularly exciting, as are the potential possibilities for combined modality therapy. It is the expressed hope that these techniques will lead to imporved results in terms of management. The appropriate management for carcinoma of the uterus is excellent for the early stages, but treatments for later stages of the disease are not settled at this time. The high probability of involvement of periaortic lymph nodes in carcinoma of the cervix warrants a more appropriate look at the treatment techniques to be employed in the management of this disease, if the maximum potential for cure is expected. In carcinoma of the ovary, various factors influencing the ultimate prognosis have now been identified; these must be taken into consideration when planning treatment. If carcinoma is known or thought to have been left in the pelvis only, vigorous postoperative pelvic irradiation is mandatory. There isvidence to suggest, however, that equally good results can be obtained in those series by the utilization of chemotherapy. In view of the frequency of seeding to the peritoneum, whole abdominal irradiation should be considered for Stage IB through Stage III carcinoma of the ovary.