Uterine cancer (corpus uteri)

This synthesis of the literature on radiotherapy for cancer originating in the endometrium of the uterus (corpus uteri) is based on 55 scientific articles, including 2 randomized studies, 1 prospective study, and 48 retrospective studies. These studies involve 13597 patients. Endometrial cancer is a radiosensitive cancer. Research findings compiled for the period 1948 to 1954 showed that 69% of the patients could be cured by radiotherapy alone. During the 1970s it was shown that combined radiotherapy and surgery yielded better results. There is agreement that patients at stage I should receive primary surgery. According to the literature, there is controversy about whether patients with poorly differentiated tumors should be given preoperative radiotherapy. Radiotherapy alone can be used successfully in patients who are inoperable because of age, general condition, or advanced spread of cancer. Vaginal postoperative radiotherapy is used in most patients and reduces the percentage of patients who develop vaginal metastases from 7%-20% to less than 1%. Patients with good prognostic factors have such a low risk for metastasis that withholding radiotherapy may be considered in this group. Postoperative external radiotherapy improves survival in patients with unfavorable prognostic factors, such as deep myometrium invasion or signs of node metastasis. Radiotherapy is delivered, in principle, to all patients with poorly differentiated disease. It can be expected that most cases of endometrial cancer will continue to be referred for some form of radiotherapy.