Alexander V. Stolbovoy

The article deals certain necessity and contemporary possibility of method of radiotherapy (RT) component in the treatment of cervical cancer (CC) which is alternative to traditional recommendations. RT of CC accordingly to main manuals begins from external beam irradiation (EBRT) and next intracavitary/interstitial brachytherapy (BT). We see this program stand stock-still during a century, despite it not rarely possible to realize oncologic problems in the care of patients. The article contains historic analysis and arguments, that advanced contemporary EBRT may be successful alternative treatment in definite part of the patients. Traditional approach doesn’t disclaim, but here are consider the situations in the article, where new personalized care is more justify. The information was searched using our key words in the bases Rosoncoweb and PubMed, in which articles selected as possible as no more five-years old, but the earliest classic publications also used. There was done retrospective search of the information according our topic from our days to the origin of treatment method of CC in the articles else. We studied Russian and international documents about methods of RT in CC. Before to send the article in the journal we searched publications according to our theme in leading Russian and foreign radiotherapy and oncology journals.

Background. Oligometastatic disease (OMD) represents an intermediate state between localized and disseminated cancer, characterized by a limited number of metastases (typically 1–5). Stereotactic ablative radiotherapy (SABR) is a precise local treatment modality capable of delivering ablative doses to metastatic lesions of various sites with minimal toxicity. Despite growing clinical evidence, the impact of primary tumor type and metastatic site on survival outcomes after SABR remains insufficiently explored. Aim — to evaluate overall survival (OS) and progression-free survival (PFS) in patients with oligometastatic disease treated with SABR, and to analyze the association of these outcomes with the localization of the primary tumor and distant metastases. Methods. This retrospective cohort study included 68 patients with 1–5 metastatic lesions treated with SABR at the European Medical Center (Moscow) between 2015 and 2024. Total radiation doses ranged from 16 to 60 Gy in 1–7 fractions, depending on tumor histology and anatomic site. The median follow-up was 51 months (range: 11–75). Forty-nine patients (72%) received systemic therapy — chemotherapy, immunotherapy, or targeted therapy — selected individually according to treatment guidelines for each tumor type and clinical status. Treatment toxicity was evaluated according to CTCAE v4.0. Results. The 1-, 3-, and 5-year OS rates were 97.1%, 83.6%, and 73.4%, respectively; corresponding PFS rates were 57.3%, 36.6%, and 28.0%. Patients with bone metastases demonstrated a tendency toward improved OS (p = 0.049), whereas the localization of the primary tumor had no significant impact on survival (p = 0.41). Grade ≥ 2 toxicity occurred in 5.8% of patients. Conclusions. SABR was associated with favorable survival outcomes and acceptable tolerance in patients with oligometastatic disease. The site of metastases may represent a prognostic factor influencing long-term outcomes. Further prospective studies are warranted to validate these findings and to refine patient selection criteria for SABR as part of combined-modality treatment.