Non-surgical treatment of malignant gynecological tumors

Non-surgical treatment of malignant gynecological tumors^[1] includes three modalities: radiotherapy, chemotherapy and hormone therapy.

Radiotherapy[edit | edit source]

In cervical carcinoma, surgical treatment is primarily indicated in the early stages, although a separate radiotherapy with curative intent can be used instead of Wertheim's radical hysterectomy. It has a comparable median survival, but it has more frequent late complications, so it is used more in cases of contraindications to surgical treatment^[1]. A combination of brachytherapy and teletherapy is used, sometimes with concomitant chemoradiotherapy. In later stages (spread outside the cervix), palliative teleradiotherapy is primarily indicated.

Brachyradiotherapy is used for cervical cancer.

Brachyradiotherapy[edit | edit source]

For cervical cancer, a uterovaginal applicator with an after-loading system is used^[1]. A Y-probe is used for endometrial cancer.

Endometrial carcinoma

¹³⁷Cs or ¹⁹²Ir^[1] are used as emitters.

Teleradiotherapy[edit | edit source]

The radiation source is a linear accelerator or betatron^[1]. For cervical cancer, a total dose of 50 Gy at 2 Gy/day is used^[1]. Sometimes concomitantly small doses of cis-platinum^[1] are used.

Concomitant chemoradiotherapy[edit | edit source]

The purpose of concomitant chemoradiotherapy is to increase the sensitivity of tumor cells to ionizing radiation. Administered chemotherapy by itself does not have cytostatic effects^[1] in these small doses.

Chemotherapy[edit | edit source]

It is used either concomitantly for cervical cancer, palliatively for stage IVB, and in some indications it can also be used neoadjuvant^[1]. Cis-platin is used intraperitoneally (IP).

For endometrial cancer, the PTX-CBDCA (paclitaxel and carboplatin) scheme is used^[1].

In ovarian cancer, chemotherapy is used either as interval debulking surgery with 3 cycles neoadjuvant, or 6 cycles after 21 days adjuvant. The standard is paclitaxel with carboplatin^[1].

Hormonal therapy[edit | edit source]

Hormonal therapy is used for endometrial cancer and lung metastases. A high dose of gestagens, antiestrogens and aromatase inhibitors^[1] is used.

Links[edit | edit source]

External links[edit | edit source]

www.onkogyn.cz (e.g. the current TNM classification, it is the website of the VFN Oncogynecological Center)

References[edit | edit source]

↑ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l FREITAG, Paul. Management of gynecological malignancies [lecture for subject Gynecology and obstetrics pre-state internship, specialization General medicine, 1. medical faculty Charles University in Prague]. Prague. 2/14/2014.

[prednaska-Freitag-1] ↑ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l FREITAG, Paul. Management of gynecological malignancies [lecture for subject Gynecology and obstetrics pre-state internship, specialization General medicine, 1. medical faculty Charles University in Prague]. Prague. 2/14/2014.

[1]