Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan.
From August 1981 to December 1986, 47 patients with endometrial cancer, surgical stage I through IV, received adjuvant whole abdominopelvic irradiation with a nodal and vaginal boost. Median age was 66.5 years (range: 37 to 86 years). Twenty-two patients were stages I-II and 25 patients were stages III-IV. Thirty-four patients (79 per cent) had positive peritoneal cytology, 29 patients (62 per cent) had deep myometrial involvement, 27 patients (58 per cent) had high-grade lesions, 18 patients (40 per cent) had either serous-papillary or adenosquamous histologic variants, and 10 patients (22 per cent) had residual disease of up to 2 cm remaining after operation, mostly in the form of nodal disease. Twenty-four patients (51 per cent) have had two or more laparotomies. Mean follow-up was 40.5 months (range: 17 to 81 months). The 5-year overall survival rate was 66 per cent, and the 5-year relapse-free survival rate was 77 per cent. Toxicity has been modest, usually of the acute type, and particularly evident in thin patients (weight below 115 pounds).