Objective: To evaluate the results of repeated radiotherapy in the pelvis region in patients with gynaecological cancer. Design: Retrospective analysis of overall survival, degree and duration of palliation as well as assessment of the toxicity profile of treatment. The authors compared their own results with data in the relevant literature. Setting: Radiotherapy and Oncology Department, Faculty Hospital Královské Vinohrady, Prague, Czech Republic. Methods: From all files of patients with carcinoma of the gynaecological tract treated in the department after the introduction of megavoltage radiotherapy those with reirradiation of at least 60 Gy in the pelvis region were reviewed. Overall survival, the extent and duration of the subjective relief, resolution of the pressure symptoms, acute and chronic treatment toxicity were analysed with respect to the anticipated predicators. Results: 21 patients were analysed. In 7/21 (33%) the symptoms (pain, bleeding, discharge, com- pression of the neighbouring structures) have been completely (temporarily or indefinitely) resol- ved. In 6/21 (29%) the effect was partial. The palliation lasted for 9-101 months (median 5 months). Statistically significant correlation was found between the palliative effect and better performan- ce status. A trend which, however, did not reach statistical significance was found between better palliation and biologically equivalent dose of the second radiotherapy course and/or application of concomitant radiochemotherapy. The toxicity of treatment was relatively mild. Conclusion: Second course of radiotherapy is an effective treatment modality in patients with persistent or recurrent gynaecological malignancies. If carefully indicated and performed, the toxicity is relatively very acceptable. Reirradiation is not recommended in patients with a very short prognosis due to advanced disease or poor general condition. Concomitant chemoradiothe- rapy can improve therapeutic ratio.

        Key words: reiradiation, overall survival, acute and chronic treatment toxicity