Gynecologic Cancer (Radiation Medicine Rounds, Volume 2, Issue 3)

140 Pages·2011·5.84 MB·English

by  Loren K. Mell MD, Arno J. Mundt MD (editor), Catheryn Yashar MD (editor), Charles R. Thomas Jr. MD (editor)

Radiation Medicine Rounds
Charles R. Thomas, Jr., MD
Editor-in-Chief
Professor and Chair
Department of Radiation Medicine
Professor, Division of Hematology/Oncology
Department of Medicine
Knight Cancer Institute
Oregon Health & Science University Cancer Institute
Portland, Oregon
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Editorial Board
Indrin J. Chetty, PhD Dwight E. Heron, MD
Detroit, Michigan Pittsburgh, Pennsylvania
T.J. Fitzgerald, MD Robert S. Lavey, MD, MPH
Worcester, Massachusetts Tampa, Florida
C. David Fuller, MD A.J. Mundt, MD
Houston, Texas San Diego, California
Iris Gibbs, MD Ramesh Rengan, MD, PhD
Stanford, California Philadelphia, Pennsylvania
Karyn A. Goodman, MD Sharon A. Spencer, MD
New York, New York Birmingham, Alabama
Chandan Guha, MD, PhD Oscar Streeter, Jr., MD
Bronx, New York Washington, DC
Michele Y. Halyard, MD Charles R. Th omas, Jr., MD
Scottsdale, Arizona Portland, Oregon
Forthcoming Issues
Breast Cancer
Alphonse Taghian and Michele Halyard
Guest Editors
Malignant Gliomas
Arnab Chakravarti and Martin Fuss
Guest Editors
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Radiation Medicine Rounds
VOLUME 2, ISSUE 3
Gynecologic Cancer
Guest Editors
Arno J. Mundt, MD
Catheryn M. Yashar, MD
Loren K. Mell, MD
Department of Radiation Oncology
University of California San Diego
San Diego, California
New York
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Acquisitions Editor: Richard Winters
Cover Design: Joe Tenerelli
Compositor: Newgen Imaging
Printer: Bradford & Bigelow
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ISSN: 2151-4208
ISBN: 978-1-936287-47-5
E-ISBN: 978-1-617050-95-4
Library of Congress Cataloging-in-Publication Data
Gynecologic cancer / guest editors, Arno J. Mundt, Catheryn M. Yashar, Loren K. Mell.
p. ; cm. -- (Radiation medicine rounds, ISSN 2151-4208 ; v. 2, issue 3)
Includes bibliographical references and index.
ISBN 978-1-936287-47-5 (alk. paper) -- ISBN 978-1-61705-095-4 (e-ISBN)
I. Mundt, Arno J. II. Yashar, Catheryn M. III. Mell, Loren K. IV. Series: Radiation medicine rounds ; v. 2, Issue 3. 2151-4208
[DNLM: 1. Genital Neoplasms, Female--therapy. W1 RA162HD v.2 issue 3 / WP 145]

616.99'46506--dc23
2011043804
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Contents
Foreword vii
Preface ix
Contributors xi
Intensity-Modulated Radiotherapy for Gynecologic Malignancies 341
Lindsay G. Jensen, Arno J. Mundt, and Loren K. Mell
In-Room Image-Guided Radiation Th erapy for Cervical Cancers 357
Mitch Kamrava, Loren K. Mell, and Catheryn M. Yashar
Image-Guided Brachytherapy in Cervical Cancer 371
Akila N. Viswanathan
Intensity-Modulated Radiotherapy in Vulvar Cancer 383
David A. Clump and Sushil Beriwal
Chemotherapy in Advanced/Recurrent Endometrial Cancer 391
Vicky Makker
Biologic Agents and Immune Th erapy in Gynecologic Cancers 401
Madeleine Courtney-Brooks and Linda R. Duska
Lymphadenectomy in Uterine Cancer 425
Elizabeth Kathleen Nugent and Donald Scott McMeekin
Robotic Surgery in Gynecologic Cancer 439
Marilyn Huang and Pedro Ramirez
Magnetic Resonance Imaging for Assessing Tumor Response in Cervical Cancer 449
Nina A. Mayr, Zhibin Huang, Simon S. Lo, and William T. C. Yuh
Index 463
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Foreword
■ FROM THE EDITOR-IN-CHIEF
Radiation Medicine Rounds is a hardcover periodical published three times a year that is designed to provide
an up-to-date review of dedicated radiation medicine topics of interest to clinicians and scientists who are
involved in the care of patients receiving radiotherapy. It is intended to serve as both a reference and an
instructional tool by students, housestaff , fellows, practicing clinicians, medical physicists, cancer biologists,
radiobiologists, and interdisciplinary colleagues throughout the oncology spectrum.
For the current issue, Gynecologic Cancer, Guest Editors Drs. Arno J. Mundt, Catheryn M. Yashar, and
Loren K. Mell have assembled a cast of highly respected thought leaders in the art of gynecologic radiation
oncology. Th ey are to be praised for delivering a well-researched, timely, and user-friendly product that covers
the state of the art for tumors of the female abdominal and pelvic reproductive tract. On behalf of the entire
Radiation Medicine Rounds editorial board, I congratulate Drs. Mundt, Yashar, and Mell for putting together
an outstanding contribution that will be useful to colleagues who are involved in the delivery of clinical care
to patients requiring radiotherapy for the major gynecologic solid tumors.
Dr. Charles R. Thomas, Jr.
Series Editor-in-Chief
Radiation Medicine Rounds
Portland, Oregon
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Preface
Th e management of patients with gynecologic cancers is truly multidisciplinary, requiring close interaction
and collaboration between gynecologic oncologists, medical oncologists, and radiation oncologists. Th is is
becoming increasingly true today as novel procedures and treatments are being developed in all three fi elds.
We thus felt it was essential to seek out leading clinicians and researchers in these disciplines, highlighting
current cutting-edge approaches for this volume of Radiation Medicine Rounds.
Th e initial section is devoted to novel radiation approaches, including intensity-modulated radiation
therapy and image-guided radiation therapy, in the planning and treatment of both external beam irradiation
and brachytherapy. Th e subsequent section focuses on the role of chemotherapy and novel biologic agents in
the treatment of gynecologic cancers. Surgical approaches are highlighted next, including the current role of
lymphadenectomy in endometrial cancer and the emerging role of robotic-assisted surgery in gynecologic can-
cers in general. Finally, an overview of the use of magnetic resonance imaging as a means of assessing tumor
response in cervical cancer patients undergoing treatment is presented.
It is our sincere hope that this Gynecologic Cancer volume succeeds in portraying the multidisciplinary
nature of gynecologic cancer management and will serve as a helpful and instructive reference for both clini-
cians and researchers alike.
Arno J. Mundt, MD
Catheryn M. Yashar, MD
Loren K. Mell, MD
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Contributors
Sushil Beriwal, MD Simon S. Lo, MD
Department of Radiation Oncology Department of Radiation Oncology
University of Pittsburgh Cancer Institute Case Western Reserve University
Pittsburgh, PA Cleveland, OH
David A. Clump, MD, PhD Vicky Makker, MD
Department of Radiation Oncology Gynecologic Medical Oncology Service
University of Pittsburgh Cancer Institute Memorial Sloan Kettering Cancer
Pittsburgh, PA Center
New York, NY
Madeleine Courtney-Brooks, MD, MPH
Department of Obstetrics and Gynecology Nina A. Mayr, MD
University of Virginia Department of Radiation Oncology
Charlottesville, VA Ohio State University
Columbus, OH
Linda R. Duska, MD
Department of Obstetrics and Gynecology Donald Scott McMeekin, MD
University of Virginia Department of Obstetrics and
Charlottesville, VA Gynecology
University of Oklahoma Health Science
Marilyn Huang, MD, MS Center
Department of Gynecologic Oncology & Oklahoma, OK
Reproductive Medicine
MD Anderson Cancer Center Loren K. Mell, MD
Houston, TX Department of Radiation Oncology
University of California San Diego
Zhibin Huang, PhD La Jolla, CA
Department of Radiation Oncology
East Carolina University Arno J. Mundt, MD
Greenville, NC Department of Radiation Oncology
University of California San Diego
Lindsay G. Jensen, MAS La Jolla, CA
Department of Radiation Oncology
University of California San Diego Elizabeth Kathleen Nugent, MD
La Jolla, CA Department of Obstetrics and Gynecology
University of Oklahoma Health Science
Mitch Kamrava, MD Center
Department of Radiation Oncology Oklahoma, OK
University of California Los Angeles
Los Angeles, CA
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xii Contributors
Pedro Ramirez, MD Catheryn M. Yashar, MD
Department of Gynecologic Oncology & Department of Radiation Oncology
Reproductive Medicine University of California San Diego
MD Anderson Cancer Center La Jolla, CA
Houston, TX
William T. C. Yuh, MD, MSEE
Akila N. Viswanathan, MD, MPH Department of Radiology
Department of Radiation Oncology Ohio State University
Brigham and Women’s Hospital/ Columbus, OH
Dana-Farber Cancer Institute
Harvard Medical School
Boston, MA
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