Endometrial

Question 1

Describe stage 1

Answer 1

Stage 1A <1/2 myometrium

Stage 1B >1/2 myometrium

Question 2

Describe stage II

Answer 2

Cervical stromal involvement

Question 3

Stage III

Answer 3

IIIA spread to serosa
IIIB vagina and or parametrium
IIIC1 pelvic nodes
IIIC2 para-aortic nodes

Question 4

Describe adjuvant management of stage I

Answer 4

IA G1/2 - no further tx
IA G3 & IB - vault brachytherapy

IB G3 - if adequate LN dissection as above, if inadequate LN staging for EBRT and no brachytherapy

Question 5

Describe management of stage II

Answer 5

Vaginal vault brachytherapy if adequate lymphadenectomy

If inadequate LN —> EBRT and brachytherapy

Question 6

Describe management of stage III

Answer 6

Adjuvant chemotherapy with carboplatin and paclitaxel

Followed by EBRT
If cervix involvement will also require brachytherapy

Question 7

What is your CTV1 in adjuvant tx

Answer 7

Vaginal vault and upper 1/2 vagina

Question 8

What is your CTv2

Answer 8

Nodal regions - proximal common iliac, internal and external iliac and obturator. 7mm around vessels

Question 9

What is your superior border?

Answer 9

2cm inferior to aortic bifurcation

Unless pelvic nodes in which case at bifurcation or 2cm above most superior node

Question 10

What is your inferior border?

Answer 10

Level of femoral heads

Question 11

What tx would you offer someone unfit for surgery?

Answer 11

45Gy/25# EBRT with 28Gy/4# HDR intracavity brachytherapy