External radiation therapy of stage I cancer of the endometrium: a need for reappraisal of this adjunctive modality.

One hundred and eighty-five patients with Stage I cancer of the endometrium were irradiated preoperatively. All were irradiated to the whole pelvis by external beam only using supermegavoltage apparati. The total mid-pelvis dose ranged from 4500 cGy/5 weeks to 5500 cGy/6 1/2 weeks. Surgery followed usually in 6 weeks. Complications were minimal. Disease-free survival at Stage IA was 92.4% 5-year, 87.7% 10-year; Stage IB was 83.5% 5-year, 74.6% 10-year. Prognosis was related to stage, grade, depth of myometrial penetration, the presence of "residual" tumor at hysterectomy. External beam preoperative irradiation is recommended for all Stage I patients; Stage IB with higher grade pathology should have intracavitary irradiation supplemental to the external irradiation.