Introduction/Background SBRT is gaining interest for delaying systemic treatment in frail patients with long-term toxicities and low disease burden (oligometastatic paradigm). However, in gynaecological pathologies, this area still lacks knowledge.

Methodology Single-centre observational study of patients with gynaecological malignancies (of any origin) who underwent stereotactic body radiotherapy (SBRT) for oligometastatic disease at our institution between 2020 until March 2023. Oligometastatic disease was defined according to the ESTRO-ASTRO 2020 consensus criteria.

The data analyzed mainly included toxicity and progression-free survival measured in months from the end of treatment to local or distant progression. Additional secondary variables were also collected.

Results Ovarian primary tumours represented 63% of the cases, followed by vulvar, endometrial, and cervical neoplasms. The treatments aimed at pulmonary (36%), nodal (27%), and other sites. The Biologically Effective Dose (BED) ranged from 65 to 116 Gy. Notably, all patients with BED >100 Gy remained progression free. 63% of patients showed no progression; those who progressed did so within four months post-SBRT. All patients had a local response, with four confirming radiologic complete responses. Only one patient died due to the progression of an intracranial lesion; the rest remain alive with no more than grade 2 toxicity.

Conclusion This study suggests SBRT can confer benefits in terms of progression-free and treatment-free intervals among gynaecological patients, providing a favourable balance between the risk of toxicities and a good quality of life. Our analysis proposes encouraging outcomes, warranting further examination.

Disclosures Owing to the limited number of patients available, additional research ought to be conducted to obtain statistically significant data.