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How should a patient be treated when they have an isolated para-aortic recurrence after upfront chemotherapy and vaginal cuff brachytherapy for intermediate risk endometrioid endometrial adenocarcinoma?

If offering radiation therapy, would you treat extended field whole pelvis or just cover the para-aortic LNs with an involved field volume? Would your recommendations vary based on the disease free interval? Would you consider just SBRT to the para-aortic lymph node?
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

We treat with salvage RT to involved nodal region (pelvis and pa if no prior EBRT and pa only if prior EBRT to pelvis) with concurrent and sequential or sequential chemotherapy using IMRT technique and using SIB dose with 55 Gy in 25 fractions to involved node and 45 Gy in 25 fractions to prophylact...

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