How would you treat a high intermediate risk stage IA grade 2 endometrial ca?

Topics: Radiation Oncology • Gynecologic Cancers

If the patient had high risk features (for example age 60+ and LVI) do you treat with vaginal brachytherapy or WPRT? If you treat with whole pelvis radiation, is there any indication for the addition of chemotherapy?

Answer from: Radiation Oncologist at Academic Institution

If it is Stage IA, Grade 2 without additional risk factors, we recommend observation. It is not considered high intermediate risk.If it is Stage IA, Grade 2 with additional risk factors such as LVI or age 60+, we recommend a referral to radiation oncology to discuss. Anecdotally, most patients will ...

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at Medical University of South Carolina
This is where evaluation of the lymph nodes would ...

at Baptist Medical Group
I used Dr. @William T. Creasman's paper (1987) whi...

Answer from: Radiation Oncologist at Academic Institution

In general, I would offer vaginal brachytherapy. I like to use the PORTEC-1&2 nomogram (Creutzberg et al., IJROBP 2015) when discussing treatment options with patients. For example, with a 60 year old with IA, grade 2 and LVI, the risk of LRR with observation would be ~ 12-13%; with vaginal brac...

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at Wake Forest University School of Medicine
Thanks, Dr. @Samuel L. Cooper! Hope you are well! ...

Answer from: Radiation Oncologist at Community Practice

Brachytherapy alone unless has substantial LVSI or p53 mutation then would consider adding EBRT especially if nodes not sampled. Chemotherapy is for p53 mutation positive. Concin et al., PMID 33397713

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Radiation Oncologist at Mon Health
Thank you @Sushil.

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