Radiotherapy of endometrial carcinoma: Who needs to be irradiated?

Abstract

Due to gynecological oncology general strategy and everyday aspiration for individual approach to malignant tumors, guidelines in treatment approach are not finally established, and they are controversial in some demands with age of the patients. If we look general treatment strategy approach to invasive endometrial cancer it is proved that operative treatment is priority and base line of treating endometrial carcinoma I and II clinical stage (FIGO) if there is general conditions for surgery, allowing complicated treatment in this age. Previous experience are showing that decision about application of therapy procedures in treatment of endometrial carcinoma every case have to has individual approach, regarding all known prognostic criteria: clinical stage, histologic type, myometrial infiltration, lymph-vascular space involvement, size of the tumor and its localization, depth of myometrial infiltration, invading of serosa, cervix and adnexa, present of hormonal tissue receptors, information about lymph node: number, size and size of the biggest metastases, data about both extra nodular expansion of tumor and peritoneal cytology. The use of postoperative radiotherapy should be limited to group of patients with highly enough risk of locoregional recurrence (15% and more) as risk warranty of morbidity connected to radiological treatment. Therefore, the goal of postoperative radiotherapy appliance is to achieve maximum locoregional disease control and survival without relapse. New Radiotherapy (RT) techniques, Conformal Radiotherapy (CFRT) and Intensity Modulated radiotherapy (IMRT), reduce the risk of complications, especially for patients with multimodal treatment. © 2008, Oncology Institute of Vojvodina, Sremska Kamenica.