Potential advantages of intensity-modulated radiation therapy in gynecologic malignancies.

Radiation therapy (RT) plays a critical role in the management of gynecologic malignancies. Conventional RT may treat a large amount of normal tissue, which results in increased toxicities and a limitation on total dose. Intensity-modulated radiation therapy (IMRT) helps reduce the dose to normal tissue while delivering a higher dose to the tissues with microscopic or gross disease. This may have a potential benefit in the treatment of gynecologic malignancies especially in difficult cases such as grossly positive nodes, recurrent disease, and vulvar cancer. However, there is very little clinical data and very little experience with the use of IMRT in gynecologic malignancies. Therefore, before complete acceptance of IMRT in the treatment of gynecologic malignancies, large multicenter trials are needed to help develop guidelines and standards.