Would you administer pelvic radiation therapy to a post-menopausal patient with locally advanced carcinosarcoma with high risk features s/p TAH/BSO with a vesico-urethral fistula that would be in the radiation therapy field?  

Although the role of adjuvant RT in uterine carcinosarcoma is unclear, it does appear that local control is enhanced. So my answer depends on "how high risk is high risk?". The question suggests that the risk of local recurrence is quite high ("locally advanced" is the descriptor), so I do think it ...

I agree the role of adjuvant radiation is not well defined and not really strong evidence to quote. The crucial thing is to define “high risk features” local vs distant. In most cases, however, failure is distal. If the patient is of good performance status and can withstand systemic ch...