Following hysterectomy without lymphadenectomy, a 64-year-old woman has grade 2 endometrioid carcinoma with outer-third myometrial invasion, lymphovascular space invasion, and age over 60. She meets criteria for high-intermediate risk. Adjuvant vaginal vault brachytherapy alone was validated against pelvic external beam radiotherapy in which trial?
- A PORTEC-1
- B PORTEC-2 ✓
- C PORTEC-3
- D ASTEC
Correct answer: B. PORTEC-2
Explanation
PORTEC-2 randomised women with high-intermediate risk features to vaginal brachytherapy versus pelvic external beam radiotherapy and showed equivalent vaginal control rates above 95 percent with far less bowel toxicity and better quality of life with brachytherapy. PORTEC-1 established the benefit of postoperative radiotherapy over no adjuvant therapy, PORTEC-3 added chemotherapy to radiotherapy in high-risk disease, and ASTEC compared radiotherapy with observation. Matching trial to population is the discriminating skill tested here.
Reference: Berek and Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.