The aim of radiotherapy is to destroy the cancer if possible without damaging the surrounding normal tissues. Two modalities of external beam radiotherapy and brachytherapy can be combined or used individually. Four parameters form the basis of radiobiology: repair, reoxygenation, repopulation and redistribution. The doses of radiotherapy employed in treating carcinoma of the cervix depend particularly on the intracavitary technique and equipment used. The design of radiotherapy for carcinoma of the cervix depends on the extent of the cancer. The radiation tolerance of normal tissues is related to the acute or chronic radiation reactions that occur in them. Primary radiotherapy may be used for patients who are unfit for surgery. Radiotherapy was formerly used in the treatment of ovarian cancer. There is a survival advantage for chemoradiation over radiotherapy alone in cervical cancer. Radiotherapy is widely used in vulval cancer as adjuvant treatment.

The investigation and management of uncommon gynaecological cancers is made based mainly on cohort studies, case series and expert opinion. Risk factors for gestational trophoblastic disease (GTD) include: maternal age, race, reproductive history, parental blood groups, and genetic predisposition. Staging for fallopian tube carcinoma is analysed by the surgical pathological system. Surgery has a limited role in the management of women with vaginal cancer. Uterine sarcomas are mesodermal tumours and account for 3-5% of all uterine cancers. FIGO has only recently introduced a staging system for these tumours to separate them from the corpus uteri staging. Uterine sarcomas are more common in black women and women who have undergone previous pelvic irradiation. Gynaecological malignancy is uncommon in childhood and adolescence. The most common malignant ovarian tumours in childhood are germ-cell carcinomas: dysgerminoma, endodermal sinus tumour, malignant teratoma and, more rarely, embryonal carcinoma, primary ovarian choriocarcinoma and mixed germ-cell tumour.

During the 1970s and 1980s, gynaecological surgeons with a special interest in oncology surgery established a number of services throughout Britain, mainly in university teaching hospitals. Most women diagnosed with cervical, uterine, ovarian, vulval or vaginal cancer continued to be managed within small district general hospitals or teaching hospitals by generalist obstetricians and gynaecologists. The Royal College of Obstetricians and Gynaecologists (RCOG) provides a complete set of standards for the provision of a streamlined service. The clinicians and commissioners should use these standards to develop national quality accounts. Research in the field of gynaecological oncology is performed as a separate entity, or the subspecialty training is extended to 3 years to include a significant component for research. Quality assurance minimum standards of care in gynaecological oncology relate to the timeliness of treatment, the functionality of multidisciplinary teams and audits of various outcomes.