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“A thing of beauty is a joy forever.” This is part of a poem by John Keats. This statement describes the impressive compilation of state of the art knowledge in this Special Issue by world leaders in gynecologic radiation oncology. We are living in an unprecedented time of rapid change in gynecologic oncology as manifested by the rapidly expanding list of therapeutics for cervical, uterine, and ovarian cancers. Pembrolizumab together with chemotherapy has recently been shown to extend survival in metastatic cervical cancer.1 PARP (poly-ADP ribose polymerase) inhibitors are routinely used in maintenance therapy in ovarian cancer,2 and we now have clinical trials for the four Cancer Genome Atlas molecular classifications of endometrial cancer.3 Radiotherapy is changing fast too, with image-guided brachytherapy shown to decrease morbidity.4 Herein, lies a wealth of modern knowledge for the practitioner in gynecologic radiation oncology.
In this Special Issue, you will discover astounding facts, such as the fact that a woman dies of cervical cancer every 2 minutes. Additionally, in certain parts of the world, children of women who die from cervical cancer have increased mortality. These facts can galvanize us as a global community to raise the bar for better treatment for women with gynecologic cancers. We are fond of the adage, “the best cancer therapies are not good enough.” The many articles herein challenge us to provide optimal and up to date care for woman with gynecologic diseases. In many instances, we understand the optimal therapy for patients; however, resources are constrained in many settings. In addition to new knowledge in this Special Issue, we learn about fixed barriers that limit implementation of appropriate care.
In this Special Issue you will find updates on classic topics in gynecologic radiation oncology, such as imaging, role of chemotherapy, indications for treatment, fractionation, and image-guided brachytherapy. You will also find emerging topics, such as immunotherapy, global issues for women with gynecologic cancers, how COVID-19 has affected care, management of human immunodeficiency virus, stereotactic body radiation therapy, and proton beam therapy.
To advance knowledge we need to communicate clearly, openly, enthusiastically, and boldly. We are grateful to the many world leaders who have provided expert contributions to this Special Issue of gynecologic radiation oncology for IJGC.
Patient consent for publication
This study does not involve human participants.
Contributors DG inception and writing. CLC and AJ editing.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests DG: serves on a DSMC committee for an international phase III industry sponsored trial and is a principal investigator (PI) of a multisite brachytherapy trial funded in part by Elekta. He is also PI of a NCI funded LAPS grant 5UG1CA233178-02 for Huntsman Cancer Institute. CLC: Research support to institution from Varian, non-financial research support to institution from Elekta, compensation to institution for time spent on independent DMC membership from MerckConsulting Agreement with Genentech, Inc.
Provenance and peer review Commissioned; internally peer reviewed.