Re-irradiation in gynecological cancers, present experiences and future hopes

Objective Treatment of recurrent diseases in patients with cervical or endometrial cancers after primary treatment by radiotherapy is challenging due to limitations of treatment options and success rates. Results are variable with contrasting outcomes and toxicities. Methods The authors reviewed all recent evidences and summarized the recent series of studies along with recent advancements and future possibilities. Results Surgical options were traditionally limited to extensive resections such as pelvic exenteration with or without intraoperative radiotherapy (IORT) or radical radiotherapy. IORT can be used as an adjunct to surgery in recurrent malignancies with positive margins. Recent interstitial brachytherapy (ISBT) studies for central recurrences have demonstrated a moderate 2 to 3 years local control of ~ 50%. Stereotactic body radiotherapy (SBRT) has also emerged as an attractive and apparently viable alternative, especially in treating relapsed nodes and pelvic sidewall disease, achieving 1- and 2-year local control rates of about 80 and 50%, respectively. Conclusion The results of salvage re irradiation are reasonable. More upcoming evidences and ongoing technological innovations will guide us in more effective retreatment and addition to life in this group of patients.