Stereotactic Body Radiation Therapy for Gynecologic Malignancies: A Case-Based Radiosurgery Society Practice Review

Ladbury, Colton; Sueyoshi, Mark H.; Brovold, Nellie M.; Kumar, Ritesh; Andraos, Therese Y.; Gogineni, Emile; Kim, Minsun; Klopp, Ann; Albuquerque, Kevin; Kunos, Charles; Leung, Eric; Mantz, Constantine; Biswas, Tithi; Beriwal, Sushil; Small, William; Erickson, Beth; Gaffney, David; Lo, Simon S.; Viswanathan, Akila N.

doi:10.1016/j.prro.2023.09.008

Cited by 2 publications

(2 citation statements)

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“…For example, SBRT as monotherapy and boost is now considered a standard option in prostate cancer [11]. In gynecologic malignancy, the ability of SBRT to mimic brachytherapy dose distributions and evidence of its use in practice is well documented [3][4][12][13]. This paper represents the first effort to publish a standard quality assurance process for safe and effective gynecologic SBRT.…”

Section: Discussionmentioning

confidence: 99%

“…Identifying the best local therapy for locally advanced, inoperable, recurrent, and oligometastatic gynecologic malignancies is often challenging [1,2]. The use of stereotactic body radiation therapy (SBRT) in the treatment of gynecologic malignancies has not been studied in a prospective clinical trial, but its use in this setting has been reported on in multiple retrospective series, as summarized by Ladbury et al [3]. Stereotactic body radiation therapy is a highly conformal, ultra-hypofractionated form of external beam radiotherapy [4].…”

Section: Introductionmentioning

confidence: 99%

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Quality Assurance for Stereotactic Body Radiation Therapy for Gynecologic Malignancies

Andersen,

Bonnen,

Ludwig

et al. 2024

Cureus

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The use of stereotactic body radiation therapy (SBRT) is not well studied or reported in the treatment of gynecologic malignancies, despite its success in the definitive management of other cancer sites. This report describes a rigorous quality assurance process for patients to undergo dose escalation to the pelvis via stereotactic photon beam irradiation. Patients who receive SBRT must be ineligible for conventional brachytherapy boost and undergo comprehensive informed consent. Fiducial placement, bowel prep, Foley catheter placement with standardized bladder filling, computerized tomography (CT) simulation with whole-body immobilization, magnetic resonance imaging (MRI)-assisted target delineation, planning aims based on the established brachytherapy literature, and physics consultation for SBRT plan optimization are necessary. Prior to each fraction, the simulation position is reproduced and verified with on-table cone beam CT, and the position is maintained with whole-body immobilization. Following treatment, the treating physician is active in survivorship and toxicity management. Gynecologic SBRT is an ongoing area of study, and preliminary successes in delivering high-quality stereotactic dose escalation suggest prospective investigation is warranted. By adhering to strict quality control measures and following a pre-defined best standard of practice, patients with gynecologic malignancies who are ineligible for traditional brachytherapy procedures can be safely treated with SBRT.

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