Dr. Mutch Discusses Radiation Versus Targeted Therapy in Endometrial Cancer

David Mutch, MD, Ira C. and Judith Gall professor, vice chair of obstetrics and gynecology, chief, Division of Gynecologic Oncology, Washington University School of Medicine, Siteman Cancer Center, discusses whether or not a patient with high-risk endometrial cancer should receive external beam radiation therapy.

There are several trials that suggest that patients with high-risk endometrial cancer should not receive external beam radiation. GOG-99 identified a high- and intermediate-risk group of patients with endometrial cancer. The findings of which showed a decreased risk of central disease but not an overall survival benefit to post-operative external beam radiation therapy.

According to Mutch, it became standard of care to give radiation therapy to this group because it decreased the risk of local recurrence, but the overall survival was the same.

That theme has been carried through the European trial PORTEC-1, with data showing that vaginal brachytherapy will decrease the local recurrence rate, as will external beam radiation therapy. However, there are more complications associated with external beam radiation therapy, prompting the Europeans to choose brachytherapy in this group of patients.