Palliative radiation therapy for gynaecological malignancies

Patients with advanced, recurrent, or metastatic gynaecological malignancie s constitute a heterogenous population with diverse symptomatology. Progres sive abdominopelvic disease can result in vaginal or diffuse pelvic bleedin g, pain, and visceral or lymphovascular obstruction. Gynaecological cancer can also develop debilitating metastases, in particular to bone, central ne rvous system, or chest. Radiation therapy is a local-regional treatment mod ality, that, when applied judiciously, can lead to substantial symptomatic relief and tumour response. Individualized application is necessary, balanc ing efficacy and patient convenience versus treatment intensity, expected d uration of palliation and potential toxicity. Important factors to consider are a patient's performance status, extent and sites of tumour, specific s ymptoms, and life expectancy. The optimal incorporation of radiotherapy is best achieved in the context of a multidisciplinary approach that addresses all facets of palliative care in patients with incurable gynaecological ma lignancies, to maximize their quality of life and functional level.