ABSTRACT
While the majority of patients diagnosed with endometrial cancer (EC) present with early stage disease, 10-15% have advanced (stage III-IV) disease at presentation. This includes patients with positive pelvic and para-aortic lymph nodes, local invasion into other pelvic organs, inoperable cancers, pelvic recurrence at the vaginal cuff or in pelvic lymph nodes, and distant metastases. The International Federation of Gynecology and Obstetrics (FIGO) revised the staging system for EC in 1989 from a clinical staging system to one based on surgical pathologic staging (1). Since that time, the definition of subgroups of pathologically staged patients and the prognostic importance of patterns of microscopic pelvic and nodal spread has been ongoing. Radiation therapy is
often used to reduce the risk of local recurrence, to treat areas of residual disease, or to palliate symptoms related to recurrent cancer. It may also be used preoperatively in technically inoperable patients, or even as the primary therapy in patients with medically inoperable disease. While radiation therapy has not been shown to improve overall survival in these situations, it is very effective therapy for both localregional control and palliation. Adjuvant radiation has a particularly important role in EC, given relatively low response rates to chemotherapeutic agents.
