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¹Department of Radiation Oncology, İstanbul University Institute of Oncology, İstanbul-Türkiye DOI : 10.5505/tjo.2025.4 Approximately 50% of cancer patients require radiotherapy (RT) during their treatment. In addition to concurrent systemic therapies for curative or adjuvant purposes, metastatic disease will require conventional fractionation or stereotactic body RT/radiosurgery (SBRT/SRS). Recently, the number of systemic treatment options has increased significantly with the introduction of immune checkpoint inhibitors (ICIs) and a wide variety of targeted agents. It is important for the radiation oncologist to be knowledgeable about targeted therapy and immunotherapy agents used in gynecologic malignancies, their side effects, and their management. Unexpected serious toxicities, such as hypertension, bleeding, thromboembolism, and a 1-2% risk of gastrointestinal perforation, can occur with bevacizumab. Therefore, concomitant administration of bevacizumab and RT is currently not recommended outside of clinical trials. An increased risk of side effects has been reported when the interval between bevacizumab and RT is <10 months. Several studies showed the association and low toxicity profile of SBRT and poly ADP-ribose polymerase inhibitors (PARPis) in patients with oligometastatic ovarian cancer. Although the concurrent use of programmed cell death protein 1/programmed cell death-ligand 1 (PD-1/PD-L1) inhibitors and RT seems appropriate in the treatment of gynecological malignancies, more data are needed regarding their use with other agents. Keywords : Adverse effects; endometrial neoplasms; immunotherapy; ovarian neoplasms; radiotherapy; targeted molecular therapy; uterine cervical neoplasms