The American Society of Clinical Oncology is supporting a guideline on postoperative radiation therapy for endometrial cancer, with some qualifications.
According to the guideline from the American Society for Radiation Oncology, surveillance only is a reasonable course of action in women without residual disease and for women with grade 1 or 2 cancer and less than 50% myometrial invasion (MI). For women with grade 1 or 2 cancer with more than 50% MI and women with grade 3 cancer with less than 50% MI, vaginal brachytherapy is as effective as pelvic radiation is at preventing recurrence and is preferable. Patients with grade 3 cancer above 50% MI will benefit from pelvic radiation therapy.
The ASCO Endorsement Panel gave several qualifications to highlight important points. Qualifications listed include the lack of survival benefit with external beam radiation therapy in early-stage disease, choosing vaginal brachytherapy over external beam radiation therapy in high-intermediate risk disease for locoregional control, chemotherapy in women with high-risk early-stage and advanced disease, the importance of clinical trials, and fertility and quality of life concerns, the panel reported.
Find the full study in the Journal of Clinical Oncology (doi:10.1200/JCO.2015.62.5459)