The organs of the female reproductive system are common sites of malignancy. Radiotherapy plays a major role in the treatment of uterine and cervical cancers, and may also be involved in the management of ovarian, vaginal and other tumours.
In general, gynaecological cancers are increasing in frequency but mortality rates have fallen due to improvements in surgical, radiotherapy and systemic therapy techniques.
Cervical cancer incidence is falling and survival has increased significantly
Uterine cancer is increasing in incidence but mortality rates have increased significantly.
Radiotherapy is indicated in:
- 60% of cervical cancer
- 45% of endometrial cancer
- 50% of vulval cancer
- 100% of vaginal cancers
- Cervical Cancer
- Uterine Cancer
- Ovarian Cancer
- Vaginal Cancer
- Vulval Cancer
- Gestational Trophoblastic Disease
The vulva includes all the external female genitalia and is an uncommon site of cancer (< 5% of female reproductive cancers). Presentation may be late due to embarrassment or neglect. Surgery is usually the main treatment unless there is involvement of the urethra, bladder or anal canal as resection of these structures requires extensive surgery and stoma formation.
- Stage IA (< 2 cm, 1 mm depth): Wide local excision alone
- Stage IB/II (< 2 cm, > 1 mm depth/> 2 cm): Radical partial vulvectomy + ipsilateral (IB) or bilateral (II) lymph node dissection
- Stage III:
Vaginal cancer is a very rare site of gynaecological malignancy, and is associated with poor outcomes relative to other sites. Small distal tumours may be well managed with surgery but larger or proximal tumours often have better outcome with radiotherapy.