Future prospects of radiotherapy in gynecologic oncology

Abstract

Major areas of progress in radiotherapy over the past decade have included important refinements in equipment and treatment techniques, as well as improved and expanded training programs for radiation oncologists. In 1975, approximately 14% of all new cancers were gynecologic, representing almost 68,000 new cases. Although end results in treatment of early cervix and corpus uteri lesions are quite good, results in treatment of early cervix and corpus uteri lesions are quite good, results in treatment of the later stage lesions, as well as ovarian and vulvo-vaginal tumors, are discouraging. Progress in the future will center around five primary areas: 1) greater understanding and utilization of radiation sensitizing agents such as hyperbaric oxygen, metronidazol, and other electroaffinic agents, purine and pyrimadine analogs, and antibiotics such as Actinomycin D and Adriamycin; 2) introduction into clinical use of high LET particle beams, such as fast neutrons, pi mesons, low atomic number nuclei, and heavy accelerated nuclei; 3) combined modality therapy utilizing radiation and chemotherapy or radiation and immunotherapy for management of subclinical disease; 4) radiobiologic and clinical advances in the utilization of radiation and hyperthermia; and 5) improved understanding of the pathophysiology and natural history of the gynecologic malignancies with increasing use of staging laparotomies, lymphangiography and peritoneoscopy.