Introduction/Background Adjuvant radiation therapy in patients with early-stage endometrial cancer type 1 is administered based on the presence of risk factors. Low and Intermediate risk patients can either be spared adjuvant therapies or undergo intravaginal vault brachytherapy to reduce local recurrence. Despite the overall excellent prognosis, yet a few patients recur loco-regionally, and radiotherapy is often the treatment of choice. This cohort study aims to assess the recurrence type and the impact of salvage radiotherapy on local control and survival.

Methodology Patients with low and intermediate risk endometrial cancer, FIGO stage 1, recurring at the vagina and/or regional lymph nodes were included. Salvage radiotherapy was the treatment of choice with or without chemotherapy. Primary endpoint is the local control rate following salvage radiotherapy. Secondary endpoints are Loco-regional Recurrence Free Survival (L.R.F.S.) and Overall Survival (O.S.).

Results 30 patients presented with loco-regional recurrence. 21 of them had received no adjuvant treatment following surgery, 5 underwent brachytherapy and 4 External Beam Radiation Therapy (E.B.R.T.) and brachytherapy boost. 19 presented with isolated vaginal vault recurrence, 5 with pelvic, 5 with para-aortic and 1 patient with inguino-femoral recurrence. Median recurrence-free survival following surgery was 28 months. 6 patients received vaginal brachytherapy as a sole treatment modality and 24 patients E.B.R.T. with or without brachytherapy boost. Platinum based chemotherapy was combined with E.B.R.T. in 4 patients. With a median follow-up following salvage radiotherapy of 46 months (mean: 51), local control rate was 80%. 4-year loco-regional recurrence free survival was 78.8% and overall survival was 89.4%. 3 out of the 4 deceased patients died from disseminated disease and 1 patient from uncontrolled local disease.

Conclusion Salvage radiotherapy following loco-regional recurrence of endometrial cancer is associated with satisfactory local control rates and excellent prognosis. It appears that radiotherapy can achieve the goal of cure for this high-risk group of patients.

Disclosures None.