Treatment of endometrial carcinoma with radiation therapy alone

Of 393 patients treated at Tufts-New England Medical Center for endometrial carcinoma from 1968-1977, 66 patients underwent radiation therapy alone because of medical contraindications to surgery. The median age for this group was 70 years. The patient distribution was Stage I (39), Stage II (11), and Stage III and IV (16). Therapy consisted of pelvic irradiation to a dose of 4000-5000 rads followed by an intrauterine radium application (3000-5000 mg hr.) and a vaginal radium application (2000-4000 rads to the surface). Local control was achieved in 37 of 50 patients with Stages I and II disease with a three-year actuarial survival of 78%. Patients with Stages III and IV disease had a median survival of 15 months; 4 of 16 patients survived for 36 months. In this group of patients, bleeding pain, and vaginal discharge was palliated. Four patients in the series had treatment-related bowel complications requiring colostomy. This is an effective method of treatment for endometrial carcinoma patients who are not surgical candidates.