• Jeffrey G Brabham and Higinia R Cardenes.
• Department of Radiation Oncology, Indiana University School of Medicine, 535 Barnhill Drive, RT041, Indianapolis, IN, 46202-5289, USA. jbrabham@iupui.edu
• Am. J. Clin. Oncol. 2009 Aug 1; 32 (4): 417-22.

ObjectiveTo examine the Indiana University experience using 198Au permanent interstitial reirradiation (198Au-IRI) in the treatment of selected patients with recurrent gynecologic malignancies.MethodsA retrospective review of 19 patients with recurrent gynecologic malignancies treated with 198Au-IRI between 1994 and 2006 was performed to evaluate disease response, local control, disease-free survival, overall survival, and toxicity.ResultsAll patients had no evidence of regional or distant metastatic disease at the time of treatment. Median age at treatment was 76 years (range, 38-87). Median tumor volume was 3.3 cm3 (range, 0.8-21.3). Median previous radiation dose from all radiation modalities was 67 Gy (range, 38.7-91.6). Median prescribed dose was 50 Gy (range, 25-55). With a median follow-up of 21 months, complete responses were obtained in 94.7% of patients, with local control being achieved after 198Au-IRI in 63.1% of patients. Including further salvage therapy, local control was ultimately achieved in 78.9% of patients. At the time of the analysis, 52.6% of patients were alive with no evidence of disease. Treatment-related toxicity was limited, with only 1 grade III toxicity (5.3%).Conclusions198Au-IRI is a safe, cost-effective, and reasonably efficacious method for controlling locally recurrent, low-volume, well-selected gynecologic malignancies, and treated with previous full-dose radiotherapy. It represents a reasonable potential therapeutic option in the salvage setting in patients who meet these criteria, particularly in women who are not candidates for or are unwilling to undergo radical salvage surgery.

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