Najjari-Jamal Dina, Cordoba Sofia, Gimeno-Morales Marta, Guevara Diana, Majercakova Katarina, Sanchez Maria, Garcia-Cabezas Sonia, Mico Soraya, Tejedor Natalia, Navarro Clara, Cerron Fernando, Pino Francisco, Muñoz Teresa, Berenguer Miguel Angel, Matute Raul, Rovirosa Angels
Radiation Oncology Department, Catalan Institute of Oncology (ICO), University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.
Radiation Oncology Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
Clin Transl Oncol. 2025 Jun 30. doi: 10.1007/s12094-025-03957-3.
Reirradiation in gynecological cancer presents significant clinical challenges due to the complexities of prior treatments and anatomical constraints. In response to the lack of standardized protocols, a Delphi-based consensus was conducted by the GINECOR group of the Spanish Society of Radiation Oncology (SEOR) and the Spanish Society of Medical Physics (SEFM). A multidisciplinary panel of radiation oncologists and medical physicists developed expert-based recommendations through a structured tow-round process. Key findings emphasize the pivotal role of brachytherapy for central and vaginal recurrences and support the use of stereotactic body radiation therapy (SBRT) for nodal disease. Other modalities such as intraoperative radiotherapy and proton therapy are considered in specialized settings. The consensus highlights the importance of individualized treatment planning, especially regarding cumulative dose constraints and organ-at-risk tolerance. Futhermore, it underscores the need for further research and prospective clinical trials to refine treatment indications and optimize outcomes in this clinical context.
由于既往治疗的复杂性和解剖学限制，妇科癌症的再程放疗面临重大临床挑战。针对缺乏标准化方案的情况，西班牙放射肿瘤学会（SEOR）的GINECOR小组和西班牙医学物理学会（SEFM）进行了基于德尔菲法的共识调研。一个由放射肿瘤学家和医学物理学家组成的多学科小组通过结构化的两轮流程制定了基于专家的建议。主要发现强调了近距离放疗在中央复发和阴道复发中的关键作用，并支持对淋巴结疾病使用立体定向体部放疗（SBRT）。在特殊情况下会考虑其他治疗方式，如术中放疗和质子治疗。该共识强调了个体化治疗计划的重要性，特别是在累积剂量限制和危及器官耐受性方面。此外，它强调需要进一步研究和开展前瞻性临床试验，以完善治疗指征并在这一临床背景下优化治疗效果。
