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?

Answer from: Radiation Oncologist at Community Practice