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Management

Radiotherapy

Some of the information within this section is taken from the ESMO clinical guidelines and its use is subject to permission from ESMO.

This is the second treatment option but radiation therapy alone is insufficient to achieve local control of the disease. It is generally used in combination with conservative surgery for patients with R0 or R1 tumours, notably lesions with microscopically positive margins or residual disease (R1) for which secondary cytoreduction is not feasible. Patients with macroscopically positive margins (R2) must  undergo secondary cytoreduction before receiving radiation therapy.

Radiation therapy should be administered postoperatively, with the best technique available, at a dose of 50–60 Gy, with fractions of 1.8–2 Gy, possibly with boosts up to 66 Gy, depending on presentation and quality of surgery. Radiotherapy may be carried out preoperatively normally using a dose of 50 Gy. IORT and brachytherapy are options in selected cases.

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