Patricia J. Eifel

During the past 15 years, there have been a host of trials published that attempt to define the indications for external beam radiation therapy and brachytherapy in patients with varying risk factors for recurrence after hysterectomy for endometrial cancer. Although these trials have helped to define a group of relatively low-risk cancers that clearly do not require adjuvant treatment, the roles of radiation therapy, chemotherapy, and lymphadenectomy are still subjects of considerable controversy. In this lecture, some of the factors that have contributed to these ambiguities will be discussed as will some practical suggestions for how the current data and guidelines can be used to make difficult decisions about individual cases. Although the technical aspects of radiation therapy delivery are less challenging than for some other gynecologic cancers, possible methods for optimizing therapeutic ratio with IMRT and brachytherapy technique will be discussed.

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