摘要Aim:High-risk endometrial cancer has a higher risk of regional and distant recurrence.We sought to examine our institutional experience regarding the timing of adjuvant radiotherapy and local failure(LF),locoregional failure(LRF),distant failure(DF),and overall survival(OS).Methods:We retrospectively reviewed a database of patients with high-risk endometrial cancer treated with sequential chemotherapy followed by adjuvant external beam radiation therapy(EBRT)with or without brachytherapy from 2012 to 2019.Results:One hundred thirty-one patients were identified.The median age at diagnosis was 65(range 32-81).The most prevalent FIGO stages were IIIB(28.2%,n = 37),IIIC1(19.8%,n = 26),and IIIA(17.6%,n = 23).Of the patients,29%(n = 38)had positive lymph nodes and 71%(n = 93)had negative lymph nodes.The most prevalent histology was endometrioid(71%,n = 93),serous(12.2%,n = 16),clear cell(9.2%,n = 12),and other(7.6%,n = 10).Moreover,100%(n = 131)of the patients completed EBRT.The mean EBRT dose was 49.6 Gy(range 45-50.4).The median number of days between surgery and EBRT was 212.4 days(range 103-219).The mean brachytherapy dose was 14.7 Gy(range 12-30).The cumulative incidence of LF was 6.1%,LRF was 19%,DF was 19%,and the median survival was 33.4 months.For patients who completed EBRT 180 days after surgery,LRF(HR 3.55[1.23-10.2],P = 0.013),LF(HR 1.91[0.4-8.9],P = 0.429),DF(HR 0.91[0.41-2],P = 0.806),and OS(HR 0.92[0.33-2.6],P = 0.87).Conclusion:In our cohort of patients with high-risk endometrial cancer treated with chemotherapy followed by radiotherapy,delaying RT was associated with an increased risk of LRF but no differences in DF or OS.