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Is it ever acceptable to treat low pelvis (vs. whole pelvis) for an early vaginal recurrence of endometrial cancer?

A patient in her 70s initially underwent TAHBSO + LNB with Stage I, G1 cancer, No LVSI. 18 months later with very small mucosal recurrence (5mm). HDR boost is planned.
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Radiation Oncology · Varian Medical Systems/Allegheny health network
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Retrospective data suggest pelvic RT helps but the volume of pelvic RT is variable as much of the data is in the 2D era. I usually treat common, external, and internal iliac in recurrent disease but would be reasonable to exclude common illiac node if morbidity is a concern.

Vargo et al., PMID 252419...

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Radiation Oncology · UAB Department of Radiation Oncology
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In general, I agree with Dr. @Dr. First Last's answer. However, a case presented here is a very favorable recurrence disease. She had low-risk endometrial cancer before surgery and also a very small mucosal recurrence. I do not have data to support and experience but I wonder if small pelvic RT with...

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Radiation Oncology · Vanderbilt-Ingram Cancer Center
Answered on

I can't think of a specific case that I would consider treating low-pelvis (meaning not treating common iliac nodes to the level of the aortic bifurcation) for a vaginal recurrence of endometrial cancer.

Perhaps someone with a significant history of IBD or other reasons to warrant toxicity concerns ...

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