Reirradiation and Total Ablative Strategies for Recurrent Gynecologic Cancer

Inclusion Criteria: * \- Age 18 years or older at the time of reirradiation or prospective enrollment. * Histologically confirmed gynecologic malignancy, including uterine, cervical, vaginal, vulvar, ovarian, fallopian tube, primary peritoneal, or rare gynecologic primary. * Documented prior radiotherapy delivered as part of previous treatment. * Recurrent or progressive disease for which reirradiation and/or total ablative strategy has been delivered, is ongoing, or is planned according to local multidisciplinary decision-making. * Recurrence or progression documented by imaging, clinical examination, pathology, and/or multidisciplinary tumor board assessment according to institutional practice. * Availability of minimum essential data, including prior radiotherapy information, date of reirradiation or planned reirradiation, disease extent at reirradiation, and at least one follow-up, outcome, or survival-status record for retrospective patients. * For prospective patients, written informed consent where required by local regulations and ethics approval. Exclusion Criteria: * No evidence of prior radiotherapy. * No reirradiation or clinically meaningful local ablative radiotherapy component delivered or planned. * Insufficient minimum data preventing assignment of reirradiation date, disease extent, or survival/follow-up status. * Exclusively polymetastatic disease with more than 5 active non-regional lesions treated without a meaningful local reirradiation or total ablative component, unless included in an exploratory non-core substudy approved by the steering committee. * Prospective refusal of consent when consent is required by local law or ethics approval.