The Role of Adjuvant Radiation Therapy for Stage i Endometrial Cancer: Does Meta-Analysis Reveal the Answer?

摘要

In this issue of the Journal, Kong and colleagues (1) have tried to improve our understanding of the role of adjuvant radiation therapy for early-stage endometrial cancer through an updated Cochrane review of existing trials. Their final conclusion, that adjuvant radiation therapy reduces the incidence of local recurrence but increases treatment-related morbidity without improving overall survival, recapitulates that of their earlier analysis (2) and is consistent with the conclusions of each of the individual trials referenced in their systematic review. It is tempting to decide that the authors' skillful summary of trial evidence allows us finally to conclude that there is no role for adjuvant pelvic radiation therapy in patients with early-stage disease. However, the data, even when combined in this summary analysis, simply do not support this generalization.