A retrospective analysis of treatment for
endometrial carcinoma is reported here. From 1987 to 1989, 138 patients were referred to the oncology department following total abdominal
hysterectomy and bilateral
salpingo-oophorectomy for
endometrial cancer. Forty-seven patients were not prescribed postoperative
radiotherapy; 31 had Stage I well differentiated
adenocarcinoma with minimal myometrial invasion, while the remaining 16 patients were considered unfit for postoperative
radiotherapy. There were no instances of local relapse amongst the 31 patients with minimal myometrial invasion. The remaining 91 patients all received external beam irradiation to the pelvis and, according to the preference of the individual therapist, 51 were prescribed additional intracavitary vault
caesium-137. Patients receiving postoperative
radiotherapy were analysed according to whether or not they received additional intracavitary vault
caesium. The two groups were also analysed for incidence of vaginal vault recurrence and treatment related morbidity. In the group receiving additional intracavitary treatment more patients had Stage II or III disease (P < 0.05), and had greater depth of myometrial invasion (P < 0.05). Vaginal vault recurrence was not observed in patients receiving intracavitary
therapy in addition to external beam
therapy. Four patients (10%) receiving external beam
therapy alone developed vaginal vault recurrence. The incidence of Kottmeier-Perez grade 2 or 3 bowel toxicity following treatment was significantly higher in those patients receiving combined treatment (18% vs. 2.5%; P = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)