[Therapeutic decisions. What is the value of radiotherapy in the treatment of adenocarcinoma of the endometrium?].

Abstract

Total hysterectomy is the most important step in the management of endometrial carcinoma.70% of endometrial carcinomas are seen in post menopausal women. Staging of these tumors depends on the histological type, the degree of penetration of these tumors and the presence of metastatic extension. Clinical evaluation of these patients, lymphangiography and surgical evaluation will complete the proper staging of the patients. Radiotherapy can be used associated with surgery either pre-surgically or post-surgically or as the only form of treatment, in those cases that are technically unresectable or with surgical contraindications or in the management of recurrent tumors or metastasis. The most widely used pre-op radiation has been intracavitary radiation following the Heyman packing technique. Some authors recommend external radiation of the pelvis with megavoltage doses of 4,000-5,000 rads and sometimes the association of internal-external radiation. Five years survival depends on staging of the disease and can vary from 75%-50%-25% or 5% for stages I through IV respectively. The incidence of vaginal metastasis after hysterectomy varies between 10-15% as opposed to an incidence of -4% after radiation.