Table 1.
Summary of case series of stereotactic radiosurgery
| Ref. | n | Cancer types | Disease setting | Dose | Response/ control rate | Survival | Grade 3/4 toxicities | Patterns of failure |
| Molla et al[3] | 16 | Cervical (7)Uterine (9) | Primary (stage 1-3) and recurrence | EBRT 45 GyTSRS 14-20 Gy/2-5 fractions +/- para-aortic boost (2 pts) | 15 pts NED at 12.6 mo (1 recurrence) | Not reported | Rectal bleeding (1) | Not reported |
| Deodato et al[13] | 11 | Ovarian (4)Cervical (4)Uterine (3) | Recurrence | SRS 20-30 Gy/4-6 fractions | 83.3% overall response rate63% recurrence at 19 mo | Not reported | None | Systemic/distant progression (n = 4)Local progression (n = 1)Local and systemic progression (n = 1) |
| Guckenburger et al[7] | 19 | Cervical (12)Uterine (7) | Recurrence | EBRT 50 GySRS 15 Gy/3 fractions+/- vaginal BT (3 pts) | 3 yr local control rate 81% | Median OS 25 mo, PFS 16 mo | Intestino-vaginal fistula (2)Small bowel ileus (1) | Systemic progression (n = 7)Local tumor progression (n = 1)Comorbid illness (n = 1)Unknown (n = 1) |
| Choi et al[10] | 30 | Cervical (28)Uterine (2) | Recurrence | EBRT 27-45 GySRS 13-45 Gy/1-3 fractions | 4 yr local control rate 67.4% | Median PFS 32 mo | Various (5) | Locoregional failure (13.8%)Distant mets (10.3%)Local and distant failure (6.9%) |
| Dewas et al[9] | 16 | Cervical (4)Uterine (1)Rectal (4)Anal (6)Bladder (1) | Recurrence | EBRT 36-66 Gy (3 pts)SRS 36 Gy/6 fractions | 1 yr local control rate 51.4% | Median OS 11.5 mo (DFS 8.3 mo) | None | Not reported |
| Haas et al[6] | 6 | Cervical (6) | Primary (stage 3B-4) | EBRT 45 GySRS 19.5-20 Gy/3-5 fractions+/- 50.4-61.2 Gy IMRT boost (5 pts) | 100% local control at 14 mo | 100% at 14 mo | None | Not reported |
| Hsieh et al[2] | 9 | Cervical (9) | Primary(stage 3B-4A) | EBRT 50.4 GySRS 15-27 Gy/5-9 fractions | 3 yr local control rate 77.8% | Median OS 13 mo | Diarrhea (1)Thrombocytopenia (1)Rectal bleeding (3)Rectovaginal fistula (1) | Distant metastases (44%) |
| Hsieh et al[2] | 31 | Uterine (31) | Primary(stage 1B-3C) | IMRT or SRS via HT 45-50.4 Gy/25-28 fractionsICBT 4.5-5 Gy x 2-6 fractions | Not reported | Median OS 21 mo | None | Distant metastases |
| Kubicek et al[19] | 11 | Cervical 7)Uterine (2)Vaginal (2) | Primary(stage 2-3C) and recurrence | EBRT or IMRT 45-50.4 GySRS 5-27.5 Gy/1-5 fractions | Not reported | 73% overall survival at follow-up | Rectal bleeding (1) | Not reported |
| Kunos et al[20] | 3 | Vulvar (3) | Recurrence | SRS 24 Gy/3 fractions | Not reported | 1-3 mo PFS | None | Out of field recurrence |
| Kunos et al[15] | 5 | Endometrial (1) 0varian (3) Cervical (1) | Recurrence | SRS 5-8 Gy x 3-5 fractions | Not reported | Not reported | Fatigue (1) | Distant metastases |
| Kunos et al[1]Phase II trial | 50 | Cervix (9) Endometrial (14)Ovarian (25) Vulvar (2) | Recurrence | SRS 24 Gy/3 fractions | 6 mo clinical benefit 68% | Median OS 20.2 mo | Hyperbilirubinemia (1)Enterovaginal fistula (1) | Out of fieldrecurrence (62%) |
EBRT: External beam radiation therapy; SRS: Stereotactic radiosurgery; NED: No evidence of disease; BT: Brachytherapy; OS: Overall survival: HT: Helical tomotherapy; IMRT: Intensity modulated radiation therapy; PFS: Progression free survival.