When do you use a vaginal cuff boost with pelvic RT for stage II endometrial cancer?

Most prospective studies studying the role of external beam in endometrial cancer have treated patients with pelvic radiation (46/2 Gy or 50.4/1.8 Gy) without any brachytherapy. These studies have reported very low rates (2-3%) of in field failure in the radiation arms, so recommending external beam...

I agree entirely with @Dr. First Last. I will add that the patients receiving external beam RT today tend to have a higher risk profile than those studied in the past, because most intermediate risk patients are now treated with vaginal cuff RT only.

To answer whether stage II patients are ever treated with VBT alone, it's not a boards answer as it's not supported by randomized data, but we have done it based on this multi-institutional analysis out of Loyola: https://www.ncbi.nlm.nih.gov/pubmed/29885996

Requirements are that the patient undergo...