The Role of the Radiotherapy in Endometrial Cancer

Endometrial cancer is the most common gynecological cancer in western countries and endometrial cancer incidence has been increased in the last few decades with increased mortality rates. Surgery has main role in the treatment of patients with endometrial cancer and adjuvant management is required in certain clinicopathological risk factors. In this study, the effect of adjuvant radiation therapy (RT) on overall survival (OS) and disease-free survival (DFS) according to risk groups in patients with endometrial cancer was evaluated retrospectively. A total of 512 patients who were diagnosed with endometrial cancer were included in the study. Based on the prognostic factors, risk groups were recorded as low, intermediate, high-intermediate, high risk, and advanced/metastatic. Patients’ OS and DFS were calculated using Kaplan– Meier method. Median age was 58 years (range, 28–82). The number of patients who had low risk group, low-intermediate risk, high-intermediate risk, high-risk and advanced risk were 139 (28%), 84 (16.9%), 50 (10.1%), 182 (36.6%) and 42 (8.5%), respectively. Median OS and DFS were 14.1 years (range, 0.1-20.7) and 1.3 years (range, 0.7-11.2), respectively. OS and DFS were found to be better in patients who received RT alone in all risk groups except the advanced/metastatic risk group (p<0.001). Currently, adjuvant therapy is no longer recommended for patients with low-risk endometrial cancer. Although adjuvant treatment is required in high- risk patients, in contrast to previous studies, the addition of chemotherapy to adjuvant RT, poor effect on prognosis in this study.