Skip to main content
SpringerLink
Log in

Adjuvant Radiation Therapy in Carcinoma Endometrium: An Update

  • Chapter
  • First Online:
Recent Advances in Endometrial Cancer

  • 353 Accesses

Abstract

In the era of personalised medicine the usage of Radiation therapy (RT) has evolved with risk adaptation approach. With many technological advancements the delivery of radiation has transformed tremendously in last two decades. Also with newer diagnostic armamentarium, better understanding of disease biology, availability of long term data on outcomes of treatment the risk criteria have been redefined in last 3 years. Currently in a diagnosed endometrial cancer, treatment is stratified based on the risk of disease recurrence which takes into account the stage of disease, histology of the tumor, and other pathologic factors. Still there are many ambiguities and the treatment is not clearly spelled out despite multiple trials. Most trials are trying to identify the subgroup of patients which can be spared the side effects of multimodality treatment. The current approach is to minimise the toxicities by prudent selection of adjuvant treatment. Further reduction in toxicities is achieved by use of contemporary modern radiation delivery machines and following strict protocols of treatment planning and delivery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Klopp A, et al. The role of postoperative radiation therapy for endometrial cancer: executive summary of an American Society for Radiation Oncology evidence-based guideline. Pract Radiat Oncol. 2014;4(3):137–44.

    Article  Google Scholar 

  2. Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, Marth C, Nout R, Querleu D, Mirza MR, Sessa C. ESMO-ESGO-ESTRO consensus conference on endometrial cancer: diagnosis, treatment and follow-up. Ann Oncol. 2016;27:16–41.

    Article  CAS  Google Scholar 

  3. Abu-Rustum NR, Zhou Q, Gomez JD, et al. A nomogram for predicting overall survival of women with endometrial cancer following primary therapy: toward improving individualized cancer care. Gynecol Oncol. 2010;116:399.

    Article  CAS  Google Scholar 

  4. Alektiar KM, Venkatraman E, Abu-Rustum N, Barakat RR. Is endometrial carcinoma intrinsically more aggressive in elderly patients? Cancer. 2003;98:2368.

    Article  Google Scholar 

  5. Keys HM, Roberts JA, Brunetto VL, et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a gynecologic oncology group study. Gynecol Oncol. 2004;92:744.

    Article  Google Scholar 

  6. Lee NK, Cheung MK, Shin JY, et al. Prognostic factors for uterine cancer in reproductive-aged women. Obstet Gynecol. 2007;109:655.

    Article  Google Scholar 

  7. Mundt AJ, Waggoner S, Yamada D, et al. Age as a prognostic factor for recurrence in patients with endometrial carcinoma. Gynecol Oncol. 2000;79:79.

    Article  CAS  Google Scholar 

  8. Shah C, Johnson EB, Everett E, et al. Does size matter? Tumor size and morphology as predictors of nodal status and recurrence in endometrial cancer. Gynecol Oncol. 2005;99:564.

    Article  Google Scholar 

  9. Wethington SL, Barrena Medel NI, Wright JD, Herzog TJ. Prognostic significance and treatment implications of positive peritoneal cytology in endometrial adenocarcinoma: unravelling a mystery. Gynecol Oncol. 2009;115:18.

    Article  Google Scholar 

  10. Garg G, Gao F, Wright JD, et al. Positive peritoneal cytology is an independent risk-factor in early stage endometrial cancer. Gynecol Oncol. 2013;128:77.

    Article  Google Scholar 

  11. Myers AP. New strategies in endometrial cancer: targeting the PI3K/mTOR pathway--the devil is in the details. Clin Cancer Res. 2013;19:5264.

    Article  CAS  Google Scholar 

  12. Mackay HJ, Eisenhauer EA, Kamel-Reid S, et al. Molecular determinants of outcome with mammalian target of rapamycin inhibition in endometrial cancer. Cancer. 2014;120:603.

    Article  CAS  Google Scholar 

  13. Sharma K, Rathi AK. Step by step radiation therapy: treatment and planning: Jaypee Brothers Medical Publishers; 2016.

    Google Scholar 

  14. Beriwal S, Jain SK, Heron DE, et al. Clinical outcome with adjuvant treatment of endometrial carcinoma using intensity-modulated radiation therapy. Gynecol Oncol. 2006;102:195.

    Article  Google Scholar 

  15. Small W Jr, Beriwal S, Demanes DJ, Dusenbery KE. American Brachytherapy Society consensus guidelines for adjuvant vaginal cuff brachytherapy after hysterectomy. Brachytherapy. 2012;11:58–67.

    Article  Google Scholar 

  16. Sorbe BG, Smeds AC. Postoperative vaginal irradiation with high dose rate after loading technique in endometrial carcinoma stage I. Int J Radiat Oncol Biol Phys. 1990;18:305–31.

    Article  CAS  Google Scholar 

  17. Kong A, Johnson N, Kitchener HC, Lawrie TA. Adjuvant radiotherapy for stage I endometrial cancer. Cochrane Database Syst Rev. 2012:CD003916.

    Google Scholar 

  18. Onsrud M, Cvancarova M, Hellebust TP, et al. Long-term outcomes after pelvic radiation for early-stage endometrial cancer. J Clin Oncol. 2013;31:3951.

    Article  Google Scholar 

  19. Sorbe B, Nordström B, Mäenpää J, et al. Intravaginal brachytherapy in FIGO stage I low-risk endometrial cancer: a controlled randomized study. Int J Gynecol Cancer. 2009;19:873.

    Article  Google Scholar 

  20. Alektiar KM, Venkatraman E, Chi DS, Barakat RR. Intravaginal brachytherapy alone for intermediate-risk endometrial cancer. Int J Radiat Oncol Biol Phys. 2005;62:111.

    Article  Google Scholar 

  21. Nout RA, Smit VT, Putter H, et al. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet. 2010;375:816.

    Article  CAS  Google Scholar 

  22. Creutzberg CL, van Putten WL, Koper PC, et al. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC study group. Post operative radiation therapy in endometrial carcinoma. Lancet. 2000;355:1404.

    Article  CAS  Google Scholar 

  23. Creutzberg CL, van Putten WL, Koper PC, et al. The morbidity of treatment for patients with stage I endometrial cancer: results from a randomized trial. Int J Radiat Oncol Biol Phys. 2001;51:1246.

    Article  CAS  Google Scholar 

  24. Creutzberg CL, Nout RA, Lybeert ML, et al. Fifteen-year radiotherapy outcomes of the randomized PORTEC-1 trial for endometrial carcinoma. Int J Radiat Oncol Biol Phys. 2011;81:e631.

    Article  Google Scholar 

  25. Parthasarathy A, Kapp DS, Cheung MK, et al. Adjuvant radiotherapy in incompletely staged IC and II endometrioid uterine cancer. Obstet Gynecol. 2007;110:1237.

    Article  Google Scholar 

  26. Scholten AN, van Putten WL, Beerman H, et al. Postoperative radiotherapy for stage 1 endometrial carcinoma: long-term outcome of the randomized PORTEC trial with central pathology review. Int J Radiat Oncol Biol Phys. 2005;63:834.

    Article  Google Scholar 

  27. Liang LW, Perez AR, Cangemi NA, et al. An assessment of prognostic factors, adjuvant treatment, and outcomes of stage IA polyp-limited versus endometrium-limited type II endometrial carcinoma. Int J Gynecol Cancer. 2016;26:497.

    Article  Google Scholar 

  28. McMeekin DS, Filiaci VL, Aghajanian C, et al. Randomized phase III trial of pelvic radiation therapy (PXRT) versus vaginal cuff brachytherapy followed by paclitaxel/carboplatin chemotherapy (VCB/C) in patients with high risk (HR), early stage endometrial cancer (EC): a gynecologic oncology group trial. Gynec Oncol. 2014;134:438.

    Article  Google Scholar 

  29. Randall M, Filiaci V, McMeekin D, et al. A phase III trial of pelvic radiation therapy versus vaginal cuff brachytherapy followed by paclitaxel/carboplatin chemotherapy in patients with high-risk, early stage endometrial cancer: a gynecology oncology group study. Int J Radiat Oncol Biol Phys. 2019;37(21):1810–8.

    CAS  Google Scholar 

  30. Bernardini MQ, Gien LT, Lau S, et al. Treatment related outcomes in high-risk endometrial carcinoma: Canadian high risk endometrial cancer consortium (CHREC). Gynecol Oncol. 2016;141:148.

    Article  Google Scholar 

  31. de Boer SM, Powell ME, Mileshkin L, et al. Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2018;19:295.

    Article  Google Scholar 

  32. de Boer SM, Powell ME, Mileshkin L, et al. Toxicity and quality of life after adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2016;17:1114.

    Article  Google Scholar 

  33. Matei D, Filiaci VL, Randall M, Steinhoff M. A randomized phase III trial of cisplatin and tumor volume directed irradiation followed by carboplatin and paclitaxel vs. carboplatin and paclitaxel for optimally debulked, advanced endometrial carcinoma. J Clin Oncol. 2017;35S:5505.

    Article  Google Scholar 

  34. Patsavas K, Woessner J, Gielda B, et al. Optimal surgical debulking in uterine papillary serous carcinoma affects survival. Gynecol Oncol. 2011;121:581.

    Article  Google Scholar 

  35. Rauh-Hain JA, Growdon WB, Schorge JO, et al. Prognostic determinants in patients with stage IIIC and IV uterine papillary serous carcinoma. Gynecol Oncol. 2010;119:299.

    Article  Google Scholar 

  36. Shih KK, Yun E, Gardner GJ, et al. Surgical cytoreduction in stage IV endometrioid endometrial carcinoma. Gynecol Oncol. 2011;122:608.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiation Oncology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India

    Kanika Sharma Sood

Authors
  1. Kanika Sharma Sood
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Obstetrics & Gynecology, Babu Jagjivan Ram Memorial Hospital, New Delhi, India

    Sumita Mehta

  2. Obstetrics and Gynecology, UCMS & GTB Hospital, Delhi, India

    Bindiya Gupta

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sood, K.S. (2020). Adjuvant Radiation Therapy in Carcinoma Endometrium: An Update. In: Mehta, S., Gupta, B. (eds) Recent Advances in Endometrial Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-15-5317-2_9

Download citation

  • DOI: https://doi.org/10.1007/978-981-15-5317-2_9

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-5316-5

  • Online ISBN: 978-981-15-5317-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation