Palliative radiotherapy in patients with recurrent gynecologic cancers

Aim of the study: The clinical analysis of patients with recurrent gynecologic cancers, who undergone palliative radiotherapy.

Material and methods: A review of 32 patients with relapsed gynecologic cancers, who undergone palliative radiotherapy between 2002-2012 was conducted. Age of patients, time from diagnosis of primary cancer to relapse, characteristics of primary tumor, indications and fractionation in palliative radiotherapy were analyzed.

Results: The study group constituted 46.9% patients with ovarian cancer, 28.1% patients with cervical cancer, 21.9% patients with endometrial cancer and 3.1% patients with vulvar cancer. The median age of patients was 61.8 ±17.6 yrs. Time from the diagnosis of primary cancer to the palliative radiotherapy was less than 3 yrs. in 78.1%, 3-5 yrs. in 15.6% and more than 5 yrs. in 6.3%. The relapse was unifocal in 43.8% and multifocal in 56.2%. In 29 patients (90.6%) only one location was irradiated: brain (14 patients), vertebral column (7 patients), long bones (3 patients), pelvis (4 patients), vulva (1 patient). In 3 cases (9.4%) two successive areas were irradiated. All calculated dose of irradiation received 90.6% of patients, and 9.4% discontinued treatment.

Conclusions: In patients with good general condition and inoperable recurrent gynecologic cancers in the central nervous system and bones the indications for palliative radiotherapy should be considered. The presence of synchronous metastases in more than one location shall not be deemed to refuse palliative radiotherapy. Appropriate qualification to palliative radiotherapy enable in most cases to complete treatment with the all calculated dose of irradiation, with good tolerance of treatment.