Endometrial carcinomas: which radiotherapy for which patient?

Area of Science:

• Gynecology
• Oncology
• Radiation Oncology

Background:

• Endometrial cancer is the third most common female malignancy, with endometrioid adenocarcinomas comprising 75-80% of cases.
• Most diagnoses (90%) occur at early stages (I or II).
• Current treatment relies on surgery and radiotherapy, but optimal sequencing and modality selection are not standardized.

Purpose of the Study:

• To clarify the optimal radiotherapy strategies for endometrial cancer patients.
• To address controversies regarding pelvic lymphadenectomy and chemotherapy in specific endometrial cancer subtypes.
• To answer the critical question of "which radiotherapy for which patient?"

Main Methods:

• Review of current treatment guidelines and clinical evidence for endometrial cancer.
• Analysis of the established roles of external beam radiotherapy and intracavitary brachytherapy.
• Evaluation of data concerning pelvic lymphadenectomy and adjuvant chemotherapy.

Main Results:

• Treatment strategies for endometrial cancer, particularly radiotherapy, remain a subject of debate.
• The precise roles of pelvic lymphadenectomy and chemotherapy for aggressive or advanced disease are not definitively established.
• While some uncertainties may be resolved, the question of personalized radiotherapy selection persists.

Conclusions:

• Optimal treatment for endometrial cancer requires further clarification, especially concerning radiotherapy modalities.
• Controversies surrounding pelvic lymphadenectomy and chemotherapy highlight the need for individualized treatment approaches.
• Further research is necessary to establish definitive, evidence-based guidelines for endometrial cancer management.