Gynecologic radiation oncology practice: retrospective analysis of a tertiary radiotherapy referral center

TL;DR

This study analyzed gynecologic cancer treatment and survival outcomes at a radiotherapy center, finding that survival rates are comparable to those in high human development index countries.

Contribution

The study provides a detailed retrospective analysis of gynecologic radiation oncology practice and survival outcomes in a tertiary referral center.

Findings

Gynecologic cancers ranked second among female malignancies in radiation oncology, with corpus uteri and cervical cancers being the most common.

Survival outcomes for most gynecologic cancers at the center were comparable to those in high human development index countries.

Abstract

This study aimed to characterize gynecologic cancers in radiation oncology practice and compare survival outcomes with those reported in countries exhibiting a high or very high human development index.

A retrospective review was conducted involving the medical records of all patients (n = 11,720) treated at our radiotherapy center between January 2012 and December 2022. Of these, 911 women with gynecologic cancers who underwent treatment and follow-up at our center were included in the analysis. Demographic, disease-related, and treatment-related characteristics, as well as relapse patterns and survival outcomes, were recorded and analyzed.

Gynecologic cancers (30%) ranked second among malignancies of women in radiation oncology, after breast cancer (35%). The two most common gynecologic cancers among all female malignancies in radiation oncology were corpus uteri cancer (20%, rank second after breast cancer) and cervical cancer (9%, rank third). With the exception of ovarian cancer, most gynecologic cancers were referred for radiotherapy at FIGO stages I–II (75%, n = 680). Curative and adjuvant radiotherapy rates were 95% (n = 771) and 75% (n = 580), respectively. The most frequently administered radiotherapy technique was external beam radiotherapy combined with brachytherapy (53%, n = 419). The rate of brachytherapy application in gynecologic radiation oncology was 82%. Palliative radiotherapy was most commonly administered for ovarian cancer (57%) in gynecologic oncology. The primary indication for palliative RT was pain management (42%). Relapse predominantly occurred as distant metastases in corpus uteri and cervical cancers, whereas other gynecologic cancers commonly exhibited locoregional disease. Survival outcomes, except for vaginal cancer, were comparable to those reported in the literature.

Gynecologic cancers constitute a substantial proportion of radiation oncology practice in women. Survival outcomes at our center largely align with those observed in countries exhibiting a high or very high human development index.

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