title: [Standards, options, and recommendations for the radiotherapy of patients with endometrial cancer. FNCLCC (National Federation of Cancer Campaign Centers) and CRLCC (Regional Cancer Campaign Centers)].
abstract: OBJECTIVE
  To develop clinical practice guidelines according to the definitions of the Standards, Options and Recommendations project for the radiotherapy of carcinoma of the endometrium.
  
  
  METHODS
  Data were identified by searching Medline and personal reference lists of members of the expert groups. Once the guidelines were defined, the document was submitted for review to independent reviewers, and to the medical committees of the 20 French Cancer Centres.
  
  
  RESULTS
  The main recommendations for the radiotherapy of carcinoma of the endometrium are: 1) For grade 1 and 2 stage IA tumours, follow-up alone is standard as additional treatment. For grade 1 and 2 stage IB tumours, vaginal brachytherapy or follow-up alone are options. For grade 3, stage IB tumours and stage IC disease, there are two treatment options: external pelvic radiotherapy with a brachytherapy boost or vaginal brachytherapy. 2) Treatment for stage II disease can be preoperative when stage II disease has been suggested by a positive endometrial curettage. Postoperative vaginal brachytherapy is given for stage IIA tumours if the penetration of the myometrium is less than 50% or if the tumour is grade 1 or 2. In the case of deep penetration, or higher grade disease, or for stage IIB external radiotherapy with brachytherapy boosting must be undertaken routinely. 3) After surgery, for stage IIIA disease, either external pelvic radiotherapy or abdomino-pelvic radiotherapy is indicated, along with medical treatment in certain patients. For stage IIIB tumours, postoperative external radiotherapy with brachytherapy (if possible) should be undertaken. For stage IIIC tumours, standard treatment is external (pelvic or pelvic and para-aortic) radiotherapy followed or not by a brachytherapy boost. In case of extrauterine sites involved abdomino-pelvic irradiation is recommended. 4) Standard treatment for inoperable stage I and II disease is external radiotherapy and brachytherapy. For patients with inoperable stage III or IV disease, treatment is often symptomatic, combining external radiotherapy and medical treatment.
authors.affiliation: Institut Bergonié, Bordeaux.
authors.forename: L
authors.initials: L
authors.lastname: Thomas
authors.forename: A
authors.initials: A
authors.lastname: Bataillard
authors.forename: A
authors.initials: A
authors.lastname: Brémond
authors.forename: E
authors.initials: E
authors.lastname: Fondrinier
authors.forename: B
authors.initials: B
authors.lastname: Fervers
authors.forename: J L
authors.initials: JL
authors.lastname: Achard
authors.forename: J
authors.initials: J
authors.lastname: Lansac
authors.forename: C
authors.initials: C
authors.lastname: Bailly
authors.forename: S
authors.initials: S
authors.lastname: Hoffstetter
authors.forename: J P
authors.initials: JP
authors.lastname: Basuyau
authors.forename: J
authors.initials: J
authors.lastname: d'Anjou
authors.forename: P
authors.initials: P
authors.lastname: Descamps
authors.forename: F
authors.initials: F
authors.lastname: Farsi
authors.forename: J P
authors.initials: JP
authors.lastname: Guastalla
authors.forename: F
authors.initials: F
authors.lastname: Laffargue
authors.forename: J F
authors.initials: JF
authors.lastname: Rodier
authors.forename: P
authors.initials: P
authors.lastname: Vincent
authors.forename: J
authors.initials: J
authors.lastname: Pigneux
mesh_terms: D001918:Brachytherapy / Q000009:adverse effects; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002588:Cesium Radioisotopes / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007205:Indium Radioisotopes / Q000627:therapeutic use; D015182:Lymphatic Irradiation / Q000009:adverse effects; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000532:radiotherapy / Q000556:secondary; D010534:Peritoneal Neoplasms / Q000532:radiotherapy / Q000556:secondary; D011184:Postoperative Period; D011300:Preoperative Care; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D011883:Radium / Q000627:therapeutic use
chemical_list: D002588:Cesium Radioisotopes; D007205:Indium Radioisotopes; D011883:Radium