**Radiation for Gynaecological Malignancies**

Papa Dasari, Singhavajhala Vivekanandam and Kandepadu Srinagesh Abhishek Raghava

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/67202

#### **Abstract**

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**66**(1): 135–41.

62 Radiotherapy

10.1155/2011/898391

Gynaecological malignancies are the most common cancers of women and they contribute to the significant amount of mortality. Women in developing countries are diagnosed in late stages and hence radiation is the common modality of therapy. Radiation is required in managing 80–90% of women with carcinoma cervix, 60% of women with endome‐ trial cancer and 50% of women with carcinoma vulva. The stage of the disease is the most important factor in survival and counselling is essential to ensure complete ther‐ apy. Radiation is used as a primary therapy, adjuvant therapy, neo‐adjuvant therapy and as palliation. The techniques include external beam radiation and brachytherapy or the combination of both. The newer techniques include IMRT‐, IGRT‐ and PET‐CT‐ guided therapies. Side effects/complications occur as acute during therapy, subacute within 3 months and chronic after 6 months. Management of these side effects is essential for increasing compliance of the patient so as to achieve high cure rates. Management of recurrent disease is a challenge and requires multidisciplinary approach involving Gynaecological Oncologist, Radiation Oncologist and Surgical Oncologist.

**Keywords:** radiotherapy, counselling, gynaecological malignancies, side effects, survival rates

## **1. Introduction**

Radiation therapy in gynaecological malignancies is an essential component in achieving cure as well as palliation. Radiotherapy is required up to 80–90% of women with carcinoma cervix, 60% of women with endometrial carcinoma, 50% of women with carcinoma vulva, all women with vaginal cancer and 5% of women with ovarian cancer. The aim of radiotherapy is to kill the tumour cells without damaging the neighbouring normal tissues. The side effects of radiation can be severe and need to be recognized early to be treated effectively. Counselling of women suffering from

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gynaecological malignancies who receive radiation is of great importance as adherence to treat‐ ment is one of the factors that influences survival rates. The most important part is the selection and categorization of women for radiation. The aim of this chapter is to appraise the readers about the burden of the gynaecological malignancies in a tertiary‐care set up, counselling and selection criteria for radiation, methods of radiation and the side effects and the outcome.

#### **1.1. Burden of gynaecological malignancies in tertiary care set up**

Cancer is the first and foremost cause of death in developing countries and the second most common cause in developed countries. Genital tract malignancies are the most common can‐ cers in women and the most common site affected is cervix followed by ovary and Uterine corpus [1]. The incidence of carcinoma cervix is 9 per 100,000 in developed countries as against 17.8 per 100,000 in developing countries. The mortality attributed to carcinoma cervix is 3.2 per 100,000 in developed regions when compared to 9.8 per 100,000 women in developing regions [2]. The cancer registry of our hospital recorded carcinoma cervix to be occurring in 70%, ovar‐ ian cancer in 20%, endometrial cancer in 9% and other cancers in 1% of cases in women. In India, every year 122,844 women were reported to be diagnosed with carcinoma cervix and 67,477 died of the disease and at present the trend of this malignancy is decreasing in incidence [3]. The incidence of carcinoma cervix has declined by 75% in developed countries [1].
