ABSTRACT
Women with advanced or recurrent endometrial cancer live less than one year largely unimpacted by current management. Combining chemotherapy and radiation therapy to improve outcome in patients with advanced endometrial cancer has been a consideration of the Gynecologic Oncology Group (GOG) for some years. Radiation targeted to prevent pelvic recurrence coupled with chemotherapy directed against intra-abdominal and systemic metastases is the current strategy. Yet, if one gave any substantial number of cycles of chemotherapy first, radiation could be delayed for weeks and greatly compromised. On the other hand, radiation given upfront could markedly reduce the ability to later give effective doses of chemotherapy. Concurrent radiation and chemotherapy does not allow for full dose chemotherapy. Radiation has to be limited to small volume residual disease (<2 cm residual tumor sites), microscopic disease, or high-risk-of-recurrence patients, while chemotherapy has no such limitations. Future directions will be guided by the culmination of findings from recent studies.
