Gynecologic Malignancies

The prognosis for women with locally advanced gynecologic tumors with direct tumor extension to pelvic sidewall structures or gross lymphatic spread to pelvic or para-aortic nodes is poor. Although high-dose external-beam radiation (EBRT) with or without brachytherapy is often utilized to treat primary locally advanced malignancies with some success, aggressive local therapy is often not considered in patients with locally advanced recurrent disease in whom standard radiation or surgical therapy has failed. This chapter summarizes the results of standard therapy for locally advanced gynecologic malignancies and presents data from series of patients treated with IORT containing regimens. The future potential of IORT in the management of locally advanced gynecologic malignancies is discussed.