Radiation Therapy in Early Stage Endometrial Cancer: Update and ...

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FIGO 1988 Surgical Staging System Early Stage Disease Stage I Corpus only IA Limited to the endometrium IB ≤1/2 myometrial invasion IC >1/2 myometrial invasion Stage II Corpus and cervix IIA Endocervical glands only IIB Cervical stromal invasion
All Patients Receive Adjuvant RT Even low grade minimally invasive tumors Postoperative RT Early Stage Disease Very Contentious Issue No Patients Receive Adjuvant RT Even high grade Deeply invasive tumors Center A Center B
Page 1 and 2: Radiation Therapy in Early Stage En
Page 3 and 4: Historical Perspective • Soon bec
Page 5 and 6: Preoperative RT Arguments Offered F
Page 7 and 8: Preoperative RT Serious complicatio
Page 9 and 10: Preoperative RT Stronger rationale
Page 11 and 12: Preoperative RT What is the preferr
Page 13 and 14: Preoperative RT Technique • ICB,
Page 15 and 16: Is there a Future for Preoperative
Page 17: Postoperative RT
Page 21 and 22: Postoperative RT Rationale • Earl
Page 23 and 24: More useful to combine grade and MI
Page 25 and 26: Rationale also provided by the corr
Page 27 and 28: Postoperative RT in Clinical Stage
Page 29 and 30: What evidence supports the use of a
Page 31 and 32: Postoperative RT Stage I-II Disease
Page 33 and 34: Retrospective studies suggest a ben
Page 35 and 36: 608 stage IA-IIA patients 22% pts w
Page 37 and 38: Clinical Stage I N=540 TAH-BSO with
Page 39 and 40: Norwegian Trial No overall benefit
Page 41 and 42: PORTEC Trial Irradiated pts had a s
Page 43 and 44: Stage IB-II (occult) N=392 TAH-BSO
Page 45 and 46: Survival Keys et al. Gynecol Oncol
Page 47 and 48: Stage IA-IIA Intermediate/High Risk
Page 49 and 50: What do these trials teach us?
Page 51 and 52: Lesson 2 Adjuvant Pelvic RT is asso
Page 53 and 54: Intensity Modulated RT • Intensit
Page 55 and 56: What do the randomized trials not t
Page 57 and 58: Is Survival Increased? • None of
Page 59 and 60: Limitation #2 Only two trials conta
Page 61 and 62: Meta-analysis of adjuvant RT in sta
Page 63 and 64: Review of SEER data 4010 stage IC g
Page 65 and 66: Immediate versus Delayed RT • Sal
Page 67 and 68: Overall Survival is Poor Particular
Page 69 and 70:
Recommendation • Adjuvant RT shou
Page 71 and 72:
Optimal Approach • Much is made o
Page 73 and 74:
With adequate surgical staging, out
Page 75 and 76:
A Phase III trial is needed compari
Page 77 and 78:
So what to do with the individual p
Page 79 and 80:
Stage I Patients Limited*/No Lymph
Page 81 and 82:
256 stage I with deep MI on 7 studi
Page 83 and 84:
In surgically staged patients, VB a
Page 85 and 86:
In stage II patients, base decision
Page 87 and 88:
As in stage I patients, one should
Page 89 and 90:
A strong rationale exists for chemo
Page 91 and 92:
The Europeans have completed such a
Page 93 and 94:
Chemotherapy alone does not control
Page 95 and 96:
Clinical Stage I-II TAH BSO Surgica
Page 97 and 98:
To test a more aggressive regimen,
Page 99 and 100:
Loco-regional control was high (>95
Page 101:
Conclusions • RT continues to pla
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Radiation Therapy in Early Stage Endometrial Cancer: Update and ...

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