 Historically, radiation therapy has been used in some form in patients diagnosed with intermediate-risk endometrial cancer. Two randomized trials published in the last 5 years have evaluated the use of adjuvant radiation therapy in patients with intermediate-risk endometrial adenocarcinoma. the Gynecologic Oncology Group GOG studied the use of adjuvant whole pelvic radiation WPRT versus no adjuvant therapy NAT in patients with stage IB, IC, and II occultendometrial adenocarcinoma. In a study of 392 patients, the use of WPRT had a substantial impact on local recurrences 18 in NAT versus 3 in WPRT, but had no impact on the risk of distant recurrence 18 NAT versus 11 in WPRT. Because of the lack of distant control, the use of WPRT did not impact overall survival estimated 4 year survival 86 in NAT versus 92 in WPRT, p0.557. The PORTEC trial randomized patients with intermediate-risk Stage I endometrial carcinoma to WPRT versus NAT. Of note, patients in this trial were not surgically staged. Of 714 patients with a median follow-up of 52 months,local recurrence rates were 4 in the WPRT group versus 14 in the control group p0.001. The use of WPRT did not impact 5-year overall survival 81 WPRT versus 85 NAT. Furthermore, some clinicians have advocated observation after surgical staging with radiation therapy reserved for those patients who recur locally. Several reports have reported salvage rates of 50-66 for patients with local recurrences. Given that approximately 20-25 patients in this population will recur locally, many clinicians prefer to use local radiation therapy as salvage therapy, thus sparing the majority of patients the potential long-term effects of pelvic radiation therapy. Given that radiation therapy does not affect distant metastasis and carries significant long-term morbidity, other therapies are necessary to improve disease-free survival in this setting. Adjuvant systemic chemotherapy is one potential option for these patients since it may sterilize both local and distant metastases. The use of adjuvant chemotherapy may be more desirable than radiation therapy because most side effects of chemotherapy are short-term and subside once therapy is completed or discontinued. 