title: The role of radiotherapy in endometrial cancer: current evidence and trends.
abstract: Adjuvant treatment of patients with endometrial cancer is tailored to clinical-pathological prognostic factors. Pelvic radiation therapy for stage I endometrial cancer (EC) provides a highly significant improvement of local control, but without survival advantage. Low-risk EC patients have a very favorable prognosis, and should be observed after surgery. Use of adjuvant radiotherapy (RT) is limited to patients with high-intermediate or high-risk factors. For those with high-intermediate risk features, vaginal brachytherapy alone provides excellent vaginal control with less morbidity and better quality of life than pelvic external beam RT (EBRT). For patients with stage I-III EC with high-risk features, the use of adjuvant chemotherapy alone has not shown survival benefit as compared to pelvic EBRT. A first trial comparing pelvic EBRT with or without adjuvant chemotherapy has shown better progression-free survival with combined therapy. Current ongoing trials are exploring the role of combined RT and chemotherapy, compared to chemotherapy or RT alone.
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, The Netherlands. c.l.creutzberg@lumc.nl
authors.forename: Carien L
authors.initials: CL
authors.lastname: Creutzberg
authors.forename: Remi A
authors.initials: RA
authors.lastname: Nout
mesh_terms: D001918:Brachytherapy / Q000379:methods; D059248:Chemoradiotherapy / Q000379:methods; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D011379:Prognosis; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic