Najjari-Jamal Dina, Rovirosa Angels, Gimeno-Morales Marta, Majercakova Katarina, Sánchez Maria, Garcia Sonia, Guevara Diana, Muñoz Teresa, De la Fuente Cristina, Micó Soraya, Stefanovic Milica, Matute Raul, Córdoba Sofia
Radiation Oncology Department, Catalan Institute of Oncology (ICO), University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.
Radiation Oncology Department, Hospital Cl¡nic IDIBAPS, University of Barcelona, Barcelona, Spain.
Clin Transl Oncol. 2025 Jun;27(6):2494-2501. doi: 10.1007/s12094-024-03804-x. Epub 2024 Dec 5.
Given the lack of standardisation in gynecological cancer reirradiation, the Gyneacologial Radiation Oncology (GINECOR) working group on behalf of the Spanish Society of Radiation Oncology (SEOR), works towards to inquire the current state of reirradiation practices among the radiation oncology departments in Spain.
An online 37-question survey was sent to all GINECOR members, representing most Spanish centers. The survey addressed general aspects of reirradiation, including experience, reirradiation sites, and techniques used. It included seven clinical case scenarios on reirradiation, and a final section on technical aspects of external beam radiotherapy (EBRT) and brachytherapy (BT) treatment. Descriptive statistics were used for data analysis.
Out of 58 centers, 29 responded, with 51.7% performing ≥ 5 reirradiation cases annually. While most centers offer multiple techniques, only 16/29 have access to BT. For in-field local relapse with surgery contraindicated, 79.3% performed BT in endometrial cancer, but only 27.5% treated with BT in cervical cancer recurrence. In this case, 17.2% used SBRT. For endometrial and cervical cancer, 44.8% and 65.4% of centers prescribed doses based on organ-at-risk tolerance, respectively. For pelvic wall/parametrial in-field relapse, 46.4% of the centres reirradiated with stereotactic body radiotherapy (SBRT), and 32.1% with BT. In nodal reirradiation, SBRT was preferred by 90% of centers. Variability was observed in target volume definitions for EBRT and proton therapy.
Reirradiation for gynecological cancer remains unstandardized, presenting significant challenges in clinical practice. To improve reirradiation protocols in gynecological cancer, the GINECOR working group is currently conducting a systematic review and formulating Delphi recommendations.
鉴于妇科癌症再程放疗缺乏标准化，妇科放射肿瘤学（GINECOR）工作组代表西班牙放射肿瘤学会（SEOR），致力于探究西班牙放射肿瘤学部门中再程放疗实践的现状。
向所有GINECOR成员发送了一份包含37个问题的在线调查问卷，这些成员代表了大多数西班牙中心。该调查涉及再程放疗的一般方面，包括经验、再程放疗部位和所使用的技术。它包括七个关于再程放疗的临床病例场景，以及关于外照射放疗（EBRT）和近距离放疗（BT）治疗技术方面的最后一部分。采用描述性统计进行数据分析。
在58个中心中，29个做出了回应，其中51.7%的中心每年进行≥5例再程放疗病例。虽然大多数中心提供多种技术，但只有16/29的中心可以进行近距离放疗。对于手术禁忌的野内局部复发，79.3%的中心对子宫内膜癌进行了近距离放疗，但宫颈癌复发时只有27.5%的中心采用近距离放疗。在这种情况下，17.2%的中心使用了立体定向体部放疗（SBRT）。对于子宫内膜癌和宫颈癌，分别有44.8%和65.4%的中心根据危及器官耐受性规定剂量。对于盆腔壁/宫旁野内复发，46.4%的中心采用立体定向体部放疗（SBRT）进行再程放疗，32.1%的中心采用近距离放疗。在淋巴结再程放疗中，90%的中心更喜欢使用SBRT。在外照射放疗（EBRT）和质子治疗的靶区体积定义中观察到了差异。
妇科癌症的再程放疗仍未标准化，在临床实践中面临重大挑战。为了改进妇科癌症的再程放疗方案，GINECOR工作组目前正在进行系统评价并制定德尔菲推荐意见。
