Stereotactic radiotherapy in the retreatment of recurrent cervical cancers, assessment of toxicity and treatment response. Initial results and literature review.

Aims. To evaluate the role of Stereotactic Body Radiation Therapy (SBRT) in the retreatment of locally recurrent cervical cancers. Brachytherapy (BT) is the main choice to treat gynaecologic cancers. Patients and Methods. Patients with recurrent cervical cancer, previously submitted to radiotherapy were treated with SBRT using a CyberKnife System (Accuray Incorporated, Sunnyvale, California) with a fiducial tracking system. Results. From August 2011 to October 2014, five patients have been treated. Median age was 81 years (range, 70-84). Two patients were diagnosed with adenocarcinoma endometrioid, three with squamous-cell carcinoma. Toxicity was scored according to RTOG/EORTC criteria. After a median follow-up of 12 months (range, 8-34), no severe (> grade-3) acute/late genitourinary (GU) or low-gastrointestinal (GI) toxicity was observed. Conclusions. Our preliminary results of SBRT‘‘simulating’’ HDR for recurrent cervical cancers confirm a minimal toxicity and an optimal outcome. The SBRT is an alternative to HDR-BT for gynecologic tumors.