Key Question 5 examines how radiation therapy and chemotherapy should be integrated in the management of endometrial cancer. The panel concluded that the best available evidence suggests that concurrent chemoradiation followed by adjuvant chemotherapy is indicated for patients with positive nodes or involved uterine serosa, ovaries/fallopian tubes, vagina, bladder or rectum. Alternative sequencing strategies with external beam radiation and chemotherapy are also acceptable. Chemotherapy or radiation therapy alone may be considered for some patients based on pathologic risk factors for pelvic recurrence.
"Several trials on the role of radiation therapy in endometrial cancer have been reported in the past five years, seeking to clarify this topic; however these trials have been interpreted in different ways, leading to inconsistent treatment recommendations," said Ann Klopp, MD, PhD, and Akila N. Viswanathan, MD, MPH, co-chairs of the ASTRO Endometrial Guideline Panel. "This guideline provides recommendations to help ensure patients receive the best possible care and to help patients and doctors make informed decisions about treatment options."
The guideline was approved by ASTRO's Board of Directors in September 2013 and is endorsed by the Society of Gynecologic Oncology. The guideline panel members included radiation oncologists, gynecologic oncologists, medical oncologists, a resident in radiation oncology and radiation physicists: Dr. Klopp (co-chair), Dr. Viswanathan (co-chair), Benjamin D. Smith, MD, Kaled Alektiar, MD, Alvin Cabrera, MD, Antonio L. Damato, PhD, Beth Erickson, MD, FASTRO, Gini Fleming, MD, David Gaffney, MD, PhD, Kathryn Greven, MD, FASTRO, Karen Lu, MD, David Miller, MD, David Moore, MD, Daniel Petereit, MD, Tracey Schefter, MD, William Small Jr., MD, FASTRO, and Catheryn Yashar, MD.
|Contact: Michelle Kirkwood|
American Society for Radiation Oncology