Beatson West of Scotland Cancer Centre, Gartnavel General Hospital, Glasgow, UK.
Clin Oncol (R Coll Radiol). 2018 Feb;30(2):110-115. doi: 10.1016/j.clon.2017.11.013. Epub 2017 Dec 9.
Re-irradiation in gynaecological malignancies has become an increasingly frequent consideration. This can be delivered in multiple settings, with the most common being a patient with a history of cervical cancer developing a new vaginal cancer or endometrial cancer with local recurrence after hysterectomy and adjuvant pelvic radiation. A systematic review of the literature has unearthed a handful of reports, most delivering brachytherapy, with a small number on both external beam radiotherapy and stereotactic ablative radiotherapy. A detailed review of these papers suggests that it is not possible to draw any firm conclusions or put forward guidelines for this challenging area of gynaecological oncology. Here the author has provided a brief account of each paper, followed by a discussion of the literature, aiming to outline some very broad principles for management. It is recommended that such patients be referred to centres that treat high volumes of gynaecological malignancies, as the experience of the treating oncologist may be the most important factor in the management of these patients.
复发性妇科恶性肿瘤已成为一个日益频繁的考虑因素。这种情况可以在多种情况下发生，最常见的是宫颈癌患者在子宫切除和辅助盆腔放疗后出现新的阴道癌或子宫内膜癌局部复发。对文献的系统回顾发现了少数几篇报告，大多数是近距离放射治疗，少数是外部束放射治疗和立体定向消融放射治疗。对这些论文的详细回顾表明，不可能对这个具有挑战性的妇科肿瘤学领域得出任何明确的结论或提出指导方针。在这里，作者简要介绍了每一篇论文，然后讨论了文献，旨在为管理制定一些非常广泛的原则。建议将此类患者转介到治疗大量妇科恶性肿瘤的中心，因为治疗肿瘤学家的经验可能是管理这些患者最重要的因素。
