The Impact of Salvage Radiotherapy in Recurrent Endometrial Cancer: A Review Focusing on Early-Stage, Endometrial Cancer Locoregional Relapses

TL;DR

This review examines how effective modern salvage radiotherapy is for treating recurrent early-stage endometrial cancer, focusing on local control and survival outcomes.

Contribution

The study evaluates recent salvage radiotherapy techniques and their impact on loco-regional recurrence in early-stage endometrial cancer patients.

Findings

Salvage radiotherapy provides excellent local control with minimal severe toxicity.

Distant control remains a major challenge, limiting overall survival rates.

Risk factors for relapse influence salvage outcomes, affecting treatment decisions.

Abstract

Background/Objectives: Definitive radiotherapy (RT) is a frequently employed salvage option in early-stage, endometrial cancer (EC) loco-regional recurrence patients. Local control (LC) and survival rates are highly variable in the literature. The aim of this review is to assess the impact of modern salvage radiotherapy (SRT) in this group of patients. Methods: A systematic review of the literature was performed, focusing on studies that included EC local recurrence patients receiving SRT after 2000 to reflect advances in radiotherapy techniques. Our report followed the principles as outlined in the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Nine studies were included in our analysis with a total sample size of 648 patients. Conclusions: SRT offers excellent LC rates in this group of patients with minimal ≥ grade 3 toxicity. Salvage rates are limited by the presence of well-known risk factors for loco-regional relapses, with distant control being the primary mode of failure, resulting in lower survival rates. The decision to omit adjuvant RT should be weighed against the anticipated salvage outcomes in case of relapse.

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