Update on radiotherapy in gynaecological malignancies

Key content This article reviews the changing role of adjuvant radiation therapy in gynaecological cancer, with emphasis on data from recent clinical trials. The evolution of practice with modern technology is improving the delivery of radiation, which has the potential to escalate doses, reduce toxicity and improve outcome. Radiation is infrequently used in ovarian cancer but in selected patients may provide good palliation. Late toxicity and survivorship issues are now recognised as important factors and there is a need to modify treatments to improve this. Learning objectives To learn and understand the changing uses of adjuvant radiation therapy in gynaecological cancer. To understand the changing practice of brachytherapy, especially with the use of imaging to allow adaptive therapy. To understand the use of high technology to improve the delivery of radiation therapy in gynaecological cancers with potential for dose escalation with improved outcome and reduced toxicities. To understand the developments in brachytherapy and the use of computerised technologies and adaptive treatments.