Is it ever acceptable to treat low pelvis (vs. whole pelvis) for an early vaginal recurrence of endometrial cancer?
A patient in her 70s initially underwent TAHBSO + LNB with Stage I, G1 cancer, No LVSI. 18 months later with very small mucosal recurrence (5mm). HDR boost is planned.
Answer from: Radiation Oncologist at Community Practice
Retrospective data suggest pelvic RT helps but the volume of pelvic RT is variable as much of the data is in the 2D era. I usually treat common, external, and internal iliac in recurrent disease but would be reasonable to exclude common illiac node if morbidity is a concern.Vargo et al., PMID 252419...
Comments
Radiation Oncologist at Maimonides Medical Center How low does the recurrence need to be before you ...
Radiation Oncologist at Varian Medical Systems/Allegheny health network My threshold is disease involving half of the vagi...
Answer from: Radiation Oncologist at Academic Institution
In general, I agree with Dr. @Beriwal's answer. However, a case presented here is a very favorable recurrence disease. She had low-risk endometrial cancer before surgery and also a very small mucosal recurrence. I do not have data to support and experience but I wonder if small pelvic RT with HDR br...
Answer from: Radiation Oncologist at Academic Institution
I can't think of a specific case that I would consider treating low-pelvis (meaning not treating common iliac nodes to the level of the aortic bifurcation) for a vaginal recurrence of endometrial cancer.
Perhaps someone with a significant history of IBD or other reasons to warrant toxicity concerns...
How low does the recurrence need to be before you ...
My threshold is disease involving half of the vagi...