In elderly patients with medical comorbidities that increase perioperative risks, surgery cannot be performed,
and definitive radiotherapy (RT) is a therapeutic option. Although staging for endometrial
cancer is based on surgical findings, clinical and radiological imaging has not been standardized yet.
For a radiological evaluation of inoperable endometrial cancer, magnetic resonance imaging (MRI) is
preferred for local tumor infiltration, and positron emission tomography is accepted as the most accurate
modality for assessing lymph node and distant metastases. External RT alone is inadequate, and
intracavitary brachytherapy with or without external RT is recommended depending on the disease
stage in patients with inoperable endometrial cancer. However, there is currently no standard treatment
approach for patients with inoperable endometrial cancer. For patients with inoperable endometrial
cancer treated with definitive RT, there are some problems including the RT technique, treatment volumes,
and systemic treatment. Based on clinical practice, image-based brachytherapy using computed
tomography and magnetic resonance imaging is highly recommended.
Keywords: Brachytherapy; endometrial cancer; inoperable; radiotherapy
