Download PDF
CC BY-NC-ND 4.0 · South Asian J Cancer 2021; 10(02): 107-111
DOI: 10.1055/s-0041-1731576
Original Article: Gynaecological Cancer

CyberKnife Stereotactic Ablative Radiotherapy for Recurrent or Oligometastatic Gynecological Cancers

Tejinder Kataria
1   Division of Radiation Oncology, Medanta - The Medicity, Gurgaon, Haryana, India
,
Pushpa Naga
1   Division of Radiation Oncology, Medanta - The Medicity, Gurgaon, Haryana, India
,
Susovan Banerjee 
1   Division of Radiation Oncology, Medanta - The Medicity, Gurgaon, Haryana, India
,
Deepak Gupta
1   Division of Radiation Oncology, Medanta - The Medicity, Gurgaon, Haryana, India
,
Kushal Narang
1   Division of Radiation Oncology, Medanta - The Medicity, Gurgaon, Haryana, India
,
Manoj Tayal
1   Division of Radiation Oncology, Medanta - The Medicity, Gurgaon, Haryana, India
,
Shyam Singh Bisht
1   Division of Radiation Oncology, Medanta - The Medicity, Gurgaon, Haryana, India
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

Purpose Use of stereotactic ablative radiotherapy (SABR) in the treatment of recurrent or metastatic lesions from a primary gynecologic cancer is a relatively new concept. The present study aims to assess the safety, efficacy, and possible toxicity profile of CyberKnife SABR, recurrent or metastatic disease.

Materials/Methods CyberKnife VSI-based SABR was offered to 20 oligometastatic/recurrent gynecological cancer patients between 2013 and 2019. Patient, tumor, and treatment characteristics including radiotherapy details, clinical outcome in terms of local control rates, and toxicities are reported in this study.

Results Twenty-five recurrent or oligometastatic lesions for 20 primary gynecologic cancer patients including cervical (n = 8), ovarian (n = 6), endometrial (n = 5), and vulvar (n = 1) cancers were analyzed. Of these, 4 (16%) were intracranial lesions and remaining 21 (84%) were extracranial, consisting of 14 (67%) extrapelvic and 7 (33%) pelvic lesions. The median SABR dose delivered was 60 Gy biologically effective dose (range 42–133 Gy) in an average of four fractions (range 1–6). The mean follow-up was 18 (range 2–70) months. Local tumor control was achieved in 82% of patients. There was no grade ≥ 3 toxicity recorded.

Conclusion Our study results suggest that CyberKnife SABR is an effective treatment modality with no major morbidity in patients with recurrent or oligometastatic gynecological cancers.

Keywords

gynecological cancer - recurrent - oligometastasis - stereotactic body radiation therapy - CyberKnife - survivals


Publication History

Article published online:
04 July 2021

© 2021. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Brady LW, Perez CA, Bedwinek JM. Failure patterns in gynecologic cancer. Int J Radiat Oncol Biol Phys 1986; 12 (04) 549-557
    CrossrefPubMedGoogle Scholar
  • 2 Niibe Y, Hayakawa K. Oligometastases and oligo-recurrence: the new era of cancer therapy. Jpn J Clin Oncol 2010; 40 (02) 107-111
    CrossrefPubMedGoogle Scholar
  • 3 Choi CW, Cho CK, Yoo SY. et al. Image-guided stereotactic body radiation therapy in patients with isolated para-aortic lymph node metastases from uterine cervical and corpus cancer. Int J Radiat Oncol Biol Phys 2009; 74 (01) 147-153
    CrossrefPubMedGoogle Scholar
  • 4 Pan H, Simpson DR, Mell LK, Mundt AJ, Lawson JD. A survey of stereotactic body radiotherapy use in the United States. Cancer 2011; 117 (19) 4566-4572
    CrossrefPubMedGoogle Scholar
  • 5 Correa RJ, Salama JK, Milano MT, Palma DA. Stereotactic body radiotherapy for oligometastasis: Opportunities for biology to guide clinical management. Cancer J 2016; 22 (04) 247-256
    CrossrefPubMedGoogle Scholar
  • 6 Lewis SL, Porceddu S, Nakamura N. et al. Definitive stereotactic body radiotherapy (SBRT) for extracranial oligometastases: an international survey of >1000 radiation oncologists. Am J Clin Oncol 2017; 40 (04) 418-422
    CrossrefPubMedGoogle Scholar
  • 7 Gomez DR, Blumenschein GR Jr, Lee JJ. et al. Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study. Lancet Oncol 2016; 17 (12) 1672-1682
    CrossrefPubMedGoogle Scholar
  • 8 Laliscia C, Fabrini MG, Delishaj D. et al. Clinical outcomes of stereotactic body radiotherapy in oligometastatic gynecological cancer. Int J Gynecol Cancer 2017; 27 (02) 396-402
    CrossrefPubMedGoogle Scholar
  • 9 Kunos C, Chen W, DeBernardo R. et al. Stereotactic body radiosurgery for pelvic relapse of gynecologic malignancies. Technol Cancer Res Treat 2009; 8 (05) 393-400
    CrossrefPubMedGoogle Scholar
  • 10 Mesko S, Sandler K, Cohen J, Konecny G, Steinberg M, Kamrava M. Clinical outcomes for stereotactic ablative radiotherapy in oligometastatic and oligoprogressive gynecological malignancies. Int J Gynecol Cancer 2017; 27 (02) 403-408
    CrossrefPubMedGoogle Scholar
  • 11 Mendez LC, Leung E, Cheung P, Barbera L. The role of stereotactic ablative body radiotherapy in gynaecological cancers: a systematic review. Clin Oncol (R Coll Radiol) 2017; 29 (06) 378-384
    CrossrefPubMedGoogle Scholar
  • 12 Palma DA, Olson R, Harrow S. et al. Stereotactic ablative radiotherapy for the comprehensive treatment of oligometastatic cancers: long-term results of the SABR-COMET phase II randomized trial. J Clin Oncol 2020; 38 (25) 2830-2838
    CrossrefPubMedGoogle Scholar
  • 13 Hasan S, Ricco A, Jenkins K. et al. Survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para-aortic region treated with stereotactic body radiation therapy. Front Oncol 2016; 6: 249
    CrossrefPubMedGoogle Scholar
  • 14 Park HJ, Chang AR, Seo Y. et al. Stereotactic body radiotherapy for recurrent or oligometastatic uterine cervix cancer: a cooperative study of the Korean Radiation Oncology Group (KROG 14-11). Anticancer Res 2015; 35 (09) 5103-5110
    Google Scholar