I. In which cases is complementary therapy required after hysterectomy? It is reasonable not to choose adjuvant radiation therapy for hysterectomy specimens without residual lesions, even if the biopsy is positive or for grade 1 or 2 cancers without invasion or <50% myometrial infiltration, especially when no other high-risk features are present. patients with grade 3 cancers without myometrial infiltration or grade 1 or 2 cancers with <50% myometrial infiltration and the presence of high-risk factors such as age >60 years and/or lymphatic interstitial invasion, then it is reasonable to receive or not receive vaginal dissection brachytherapy. II. In which cases is vaginal dissection radiotherapy required after hysterectomy? The evidence suggests that brachytherapy is similar to pelvic radiotherapy in preventing recurrence of vaginal dissection in patients with grade 1 or 2 cancer with ≥50% myometrial infiltration or grade 3 cancer with <50% myometrial infiltration. For patients with these risk factors, especially those evaluated by comprehensive lymph node assessment, brachytherapy to the vaginal dissection is superior to pelvic radiotherapy. C. Under what circumstances do I need external radiation radiotherapy after hysterectomy? Patients with grade 3 early endometrial cancer with ≥50% myometrial infiltration or cervical stromal infiltration are considered to receive pelvic radiotherapy to reduce the risk of pelvic recurrence. Patients with grade 1 or 2 cancer and ≥50% myxoid infiltration of the tumor may also receive pelvic radiotherapy to reduce the risk of pelvic recurrence if other risk factors such as age >60 years and/or vascular infiltration are present. The best evidence suggests that treatment including external radiation radiotherapy and adjuvant chemotherapy should be used for patients with positive lymph nodes or involvement of the uterine plasma membrane, ovaries and fallopian tubes, vagina, bladder or rectum. Chemotherapy or radiation monotherapy may be used for certain patients with pathologic risk factors for pelvic recurrence. IV. Is additional brachytherapy necessary after external irradiation? There is a lack of data to validate the effectiveness of using brachytherapy after pelvic radiotherapy, and the sample size enrolled in the retrospective study was too small to give conclusive evidence about the benefit. Patients receiving external pelvic radiation radiotherapy may not require simultaneous vaginal brachytherapy unless the patient has risk factors for vaginal recurrence. V. How are radiotherapy and chemotherapy integrated in the comprehensive management of endometrial cancer? Evidence suggests that concurrent radiotherapy-chemotherapy sequential adjuvant chemotherapy is recommended for patients with positive lymph nodes or involvement of the uterine plasma membrane, ovaries and fallopian tubes, vagina, bladder or rectum. Alternative procedural treatment strategies may also be external radiation radiotherapy plus chemotherapy. Chemotherapy or radiation monotherapy may be used for certain patients with risk factors for pelvic recurrence pathology.