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To the Editor.—
The article by Wilson (1980;244:1837) stresses that his "preferred technique is... preoperative radiation, external radiation, external pelvic irradiation to 5,400 rad in six weeks, followed by... intracavitary insertion."That regimen requires a hospitalization for a dilation and curettage (D&C) (for "precise staging"), then six weeks of external irradiation followed by a second hospitalization for "single intracavitary treatment," and then an immediate hysterectomy (or one delayed for several weeks). So the treatment course for stage I endometrial cancer (G2 or G3) is about three months, with three operations under general anesthesia. However, women with endometrial cancer may be elderly, and they often cannot tolerate 5,400 rad in six weeks and three operations under general anesthesia.The external radiation, a dose of 5,400 rad to the whole pelvis, should be reserved for those patients with anaplastic tumors as evidenced by a D&C specimen or with known deep penetration determined
Simon N. Treatment of Endometrial Cancer. JAMA. 1981;246(9):938-939. doi:10.1001/jama.1981.03320090014012