In a surgically staged Stage II Grade 1 endometrial adenocarcinoma, with no other high risk factors, would you treat with brachytherapy alone or add on the pelvic RT?
NCCN recommends brachytherapy plus or minus pelvic RT for surgically staged Grade 1, Stage II patients, but these originally staged IIB patients were not included in PORTEC 2 so not sure what data there is to support eliminating pelvic RT in this subset.
Answer from: Radiation Oncologist at Academic Institution
In our study of Stage II patients treated with VBT alone, pelvic failure was low, at only 4% at 5 years of follow up. When looking at patients with the most favorable features—microscopic Stage II, G1-2, no LVI, FIGO IA, with a nodal assessment—there were no pelvic failures among 31 pati...
Answer from: Radiation Oncologist at Community Practice
I agree with all above responses. One must evaluate all risk features, but in low grade (1/2) no LVSI, depth of invasion of cervical stroma are important factors to consider, and in most of these patients, vault only would be sufficient.We recently published our data, and did find that patients with...
Answer from: Radiation Oncologist at Academic Institution
I agree with the above opinions, if no other risk factors were identified and all surgical margins are Path negative.
Comments
Radiation Oncologist at University of Cincinnati College of Medicine
This recent data is helpful. Pelvic failure is qui...
This recent data is helpful. Pelvic failure is qui...
Radiation Oncologist at Bismarck Cancer Center
Reference citations in support of the approach, in...
Reference citations in support of the approach, in...
Radiation Oncologist at CancerCare Manitoba
We treat with VBT alone if there are no high risk ...
We treat with VBT alone if there are no high risk ...
Our practice is consistent with @Sushil Beriwal&rs...