Copyright ©2014 Baishideng Publishing Group Inc.
World J Radiol. Jun 28, 2014; 6(6): 366-373
Published online Jun 28, 2014. doi: 10.4329/wjr.v6.i6.366
Table 1 Summary of case series of stereotactic radiosurgery
Ref.nCancer typesDisease settingDoseResponse/ control rateSurvivalGrade 3/4 toxicitiesPatterns of failure
Molla et al[3]16Cervical (7)Uterine (9)Primary (stage 1-3) and recurrenceEBRT 45 GyTSRS 14-20 Gy/2-5 fractions +/- para-aortic boost (2 pts)15 pts NED at 12.6 mo (1 recurrence)Not reportedRectal bleeding (1)Not reported
Deodato et al[13]11Ovarian (4)Cervical (4)Uterine (3)RecurrenceSRS 20-30 Gy/4-6 fractions83.3% overall response rate63% recurrence at 19 moNot reportedNoneSystemic/distant progression (n = 4)Local progression (n = 1)Local and systemic progression (n = 1)
Guckenburger et al[7]19Cervical (12)Uterine (7)RecurrenceEBRT 50 GySRS 15 Gy/3 fractions+/- vaginal BT (3 pts)3 yr local control rate 81%Median OS 25 mo, PFS 16 moIntestino-vaginal fistula (2)Small bowel ileus (1)Systemic progression (n = 7)Local tumor progression (n = 1)Comorbid illness (n = 1)Unknown (n = 1)
Choi et al[10]30Cervical (28)Uterine (2)RecurrenceEBRT 27-45 GySRS 13-45 Gy/1-3 fractions4 yr local control rate 67.4%Median PFS 32 moVarious (5)Locoregional failure (13.8%)Distant mets (10.3%)Local and distant failure (6.9%)
Dewas et al[9]16Cervical (4)Uterine (1)Rectal (4)Anal (6)Bladder (1)RecurrenceEBRT 36-66 Gy (3 pts)SRS 36 Gy/6 fractions1 yr local control rate 51.4%Median OS 11.5 mo (DFS 8.3 mo)NoneNot reported
Haas et al[6]6Cervical (6)Primary (stage 3B-4)EBRT 45 GySRS 19.5-20 Gy/3-5 fractions+/- 50.4-61.2 Gy IMRT boost (5 pts)100% local control at 14 mo100% at 14 moNoneNot reported
Hsieh et al[2]9Cervical (9)Primary(stage 3B-4A)EBRT 50.4 GySRS 15-27 Gy/5-9 fractions3 yr local control rate 77.8%Median OS 13 moDiarrhea (1)Thrombocytopenia (1)Rectal bleeding (3)Rectovaginal fistula (1)Distant metastases (44%)
Hsieh et al[2]31Uterine (31)Primary(stage 1B-3C)IMRT or SRS via HT 45-50.4 Gy/25-28 fractionsICBT 4.5-5 Gy x 2-6 fractionsNot reportedMedian OS 21 moNoneDistant metastases
Kubicek et al[19]11Cervical 7)Uterine (2)Vaginal (2)Primary(stage 2-3C) and recurrenceEBRT or IMRT 45-50.4 GySRS 5-27.5 Gy/1-5 fractionsNot reported73% overall survival at follow-upRectal bleeding (1)Not reported
Kunos et al[20]3Vulvar (3)RecurrenceSRS 24 Gy/3 fractionsNot reported1-3 mo PFSNoneOut of field recurrence
Kunos et al[15]5Endometrial (1) 0varian (3) Cervical (1)RecurrenceSRS 5-8 Gy x 3-5 fractionsNot reportedNot reportedFatigue (1)Distant metastases
Kunos et al[1]Phase II trial50Cervix (9) Endometrial (14)Ovarian (25) Vulvar (2)RecurrenceSRS 24 Gy/3 fractions6 mo clinical benefit 68%Median OS 20.2 moHyperbilirubinemia (1)Enterovaginal fistula (1)Out of fieldrecurrence (62%)
Table 2 Indications for SRS in recurrent and metastatic gynecologic malignancy
Recurrent cervical cancerRecurrence in a previously radiated fields
Recurrence in patients who are not candidates for pelvic exenteration
Complex oligometastasesUnresectable oligometastases
Oligometastases in abdominal retroperitoneum
Central nervous system and brain metastasesIntracranial lesions not accessible to Gamma Knife