以全骨盆（WP）铅笔束扫描质子放射治疗（PBS PRT）评估妇科恶性肿瘤的长期毒性和疾病结果。我们回顾了2013年至2019年接受WP PBS PRT治疗的23名患者，包括子宫内膜癌、宫颈癌和阴道癌。我们报告了通过不良事件共同术语分类（版本5）分级的急性和晚期G2+毒性。疾病结果采用Kaplan-Meier法进行评估。中位年龄为59岁。中位随访时间为4.8年。其中12例（52.2％）为子宫癌，10例（43.5％）为宫颈癌，1例（4.3％）为阴道癌。20例（86.9％）接受子宫切除术后治疗。22例（95.7％）接受化疗，其中12例（52.2％）行同时放疗。PBS PRT的中位剂量为50.4GyRBE（范围为45-62.5）。8名（34.8％）患者为腹主动脉/扩展区域照射。10例（43.5％）患者接受了放射治疗增强。中位随访时间为4.8年。5年累积局部控制率为95.2％，区域控制率为90.9％，远端控制率为74.7％，疾病控制和无进展生存率为71.2％。总生存率为91.3％。在急性期，有2例（8.7％）患者出现了G2泌尿生殖系统（GU）毒性，6例（26.1％）患者出现了胃肠道（GI）G2-3毒性，17例（73.9％）患者出现了G2-4血液学（H）毒性。在晚期，有3例（13.0％）患者出现了G2 GU毒性，1例（4.3％）患者出现了G2 GI毒性，2例（8.7％）患者出现了G2-3H毒性。平均小肠V15Gy为213.4cc。平均大肠V15Gy为131.9cc。WP PBS PRT对于妇科恶性肿瘤提供了有利的局部控制效果。GU和GI毒性率较低。急性H毒性是最常见的，可能与大部分患者接受化疗有关。版权所有 © 2023 Elsevier Inc.。

To characterize long-term toxicity and disease outcomes with whole pelvis (WP) pencil beam scanning proton radiation therapy (PBS PRT) for gynecologic malignancies.We reviewed 23 patients treated from 2013 to 2019 with WP PBS PRT for endometrial, cervical, and vaginal cancer. We report acute and late Grade (G)2+ toxicities, graded by Common Terminology Criteria for Adverse Events, Version 5. Disease outcomes were assessed by Kaplan-Meier method.Median age was 59 years. Median follow up was 4.8 years. 12 (52.2%) had uterine cancer, 10 (43.5%) cervical, 1 (4.3%) vaginal. 20 (86.9%) were treated post-hysterectomy. 22 (95.7%) received chemotherapy, 12 concurrently (52.2%). The median PBS PRT dose was 50.4GyRBE (range, 45-62.5). 8 (34.8% had para-aortic/extended fields. 10 (43.5%) received brachytherapy boost. Median follow up was 4.8 years. 5-year actuarial local control was 95.2%, regional control 90.9%, distant control 74.7%, both disease control and progression-free survival 71.2%. Overall survival was 91.3%. In the acute period, 2 patients (8.7%) had G2 genitourinary (GU) toxicity, 6 (26.1%) had gastrointestinal (GI) G2-3 toxicity, 17 (73.9%) had G2-4 hematologic (H) toxicity. In the late period, 3 (13.0%) had G2 GU toxicity, 1 (4.3%) had G2 GI toxicity, 2 (8.7%) had G2-3H toxicity. The mean small bowel V15Gy was 213.4 cc. Mean large bowel V15 Gy was 131.9 cc.WP PBS PRT for gynecologic malignancies delivers favorable locoregional control. Rates of GU and GI toxicity are low. Acute hematologic toxicity was most common, which may be related to the large proportion of patients receiving chemotherapy.Copyright © 2023 Elsevier Inc. All rights reserved.