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CompletedNCT00376844PORTEC-2Updated Apr 12, 2022

External-Beam Radiation Therapy Compared With Vaginal Brachytherapy After Surgery for Stage I Endometrial Cancer

A Phase 3 interventional study of External Beam Radiation Therapy and Vaginal Brachytherapy in Endometrial Cancer, sponsored by Leiden University. Completed at 1 site in Netherlands. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-04-12.

Sponsored by Leiden University · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
427
Allocation
Randomized
Ages
18 Years and older
Sex
Female
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Study summary

RATIONALE: External-beam radiation therapy uses high-energy x-rays to kill tumor cells. Implant radiation therapy uses radioactive material placed directly into or near a tumor to kill tumor cells. Giving external-beam radiation therapy or implant radiation therapy after surgery may kill any tumor cells that remain after surgery. Sometimes, after surgery, the tumor may not need more treatment until it progresses. In this case, observation may be sufficient. It is not yet known whether radiation therapy is more effective than observation when given after surgery in treating stage I endometrial cancer.

PURPOSE: This randomized phase III trial is studying external-beam radiation therapy or implant radiation therapy to see how well they work compared with observation in treating patients who have undergone surgery for stage I endometrial cancer.

Read the detailed description

OBJECTIVES:

  • Compare the rate of 5-year locoregional relapse in patients undergoing external-beam radiotherapy or vaginal brachytherapy vs observation only after surgery for stage I endometrial cancer.
  • Compare 5-year rate of distant metastases in these patients.
  • Determine overall survival rate in these patients.
  • Determine prognostic factors for relapse and morbidity.

OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients undergo either vaginal brachytherapy or external-beam radiotherapy.
  • Arm II: Patients are observed and undergo no further treatment. After completion of study treatment, patients are followed for approximately 83 days.

PROJECTED ACCRUAL: A total of 400 patients will be accrued for this study.

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Conditions studied

  • Endometrial Cancer

Keywords

  • stage I endometrial carcinoma
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In context

Endometrial Neoplasms

1,325 studies on the registry are indexed under Endometrial Neoplasms; 447 are open to participants now.

This study's enrollment of 427 is above the median of 70 across 941 interventional studies indexed under Endometrial Neoplasms.

Browse Endometrial Neoplasms studies →

Lead sponsor

Leiden University is the lead sponsor of 19 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Diagnosis of FIGO 1988 stage I-IIA endometrial cancer, meeting 1 of the following criteria:

    • Age ≥60, stage IC grade 1 or 2 with deep (≥ 50%) myometrial invasion
    • Age ≥60, stage IB grade 2 or 3 (with \< 50% myometrial invasion)
    • Stage IIA, any age
  • No grade 3 endometrial carcinoma with deep myometrial invasion
  • Total abdominal hysterectomy and bilateral salpingo-oophorectomy required prior to randomisation
  • WHO performance status 0-2

Exclusion criteria

EXCLUSION CRITERIA:

  • Serous or clear cell histology or uterine sarcoma
  • staging lymphadenectomy
  • interval between surgery and radiotherapy > 8 weeks
  • history of previous malignant disease (except basal cell carcinoma of skin)
  • previous radiotherapy, hormonal therapy or chemotherapy
  • diagnosis of Chrohn's disease or ulcerative colitis
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Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
427 participants (actual)

Study arms

  • Active comparator
    External Beam Radiation Therapy

    Postoperative pelvic radiotherapy

    Radiation: External Beam Radiation Therapy

  • Experimental
    Vaginal Brachytherapy

    Postoperative vaginal brachytherapy

    Radiation: Vaginal Brachytherapy

Interventions

  • RadiationExternal Beam Radiation Therapy

    Also known as: pelvic radiotherapy

  • RadiationVaginal Brachytherapy

    Also known as: internal radiation

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What researchers measure

Primary outcomes

  1. Vaginal relapse

    total vaginal relapse and vaginal relapse as first failure

    Time frame: 5 years

Secondary outcomes

  1. Rate of distant metastases

    total distant relapse and distant relapse as first failure

    Time frame: 5 years

  2. Overall survival

    all-cause survival (and cancer-related survival)

    Time frame: 5 years

  3. Adverse effects

    Types and severity graded according to EORTC-RTOG grading system

    Time frame: 5 years

  4. Health-related quality of life

    Cancer-specific quality of life (EORTC QLQ C-30); patient reported symptoms

    Time frame: 5 years

  5. Pelvic relapse

    total pelvic relapse and pelvic relapse as first failure

    Time frame: 5 years

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Study locations

1 site
  • Leiden University Medical Center
    Leiden, 2300 RC, Netherlands
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References and documents

Publications

  • McCloskey SA, Tchabo NE, Malhotra HK, Odunsi K, Rodabaugh K, Singhal P, Lele S, Jaggernauth W. Adjuvant vaginal brachytherapy alone for high risk localized endometrial cancer as defined by the three major randomized trials of adjuvant pelvic radiation. Gynecol Oncol. 2010 Mar;116(3):404-7. doi: 10.1016/j.ygyno.2009.06.027. Epub 2009 Nov 27. PubMed 19944453 ↗
  • Nout RA, Putter H, Jurgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, Mens JW, Slot A, Stenfert Kroese MC, Nijman HW, van de Poll-Franse LV, Creutzberg CL. Five-year quality of life of endometrial cancer patients treated in the randomised Post Operative Radiation Therapy in Endometrial Cancer (PORTEC-2) trial and comparison with norm data. Eur J Cancer. 2012 Jul;48(11):1638-48. doi: 10.1016/j.ejca.2011.11.014. Epub 2011 Dec 14. PubMed 22176868 ↗
  • Nout RA, Putter H, Jurgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, Mens JW, Slot A, Stenfert Kroese MC, van Bunningen BN, Smit VT, Nijman HW, van den Tol PP, Creutzberg CL. Quality of life after pelvic radiotherapy or vaginal brachytherapy for endometrial cancer: first results of the randomized PORTEC-2 trial. J Clin Oncol. 2009 Jul 20;27(21):3547-56. doi: 10.1200/JCO.2008.20.2424. Epub 2009 Jun 22. PubMed 19546404 ↗
  • Nout RA, Putter H, Jürgenliemk-Schulz IM, et al.: Vaginal brachytherapy versus external beam pelvic radiotherapy for high-intermediate risk endometrial cancer: Results of the randomized PORTEC-2 trial. [Abstract] J Clin Oncol 26 (Suppl 15): A-LBA5503, 2008.
  • Nout RA, Smit VT, Putter H, Jurgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, Mens JW, Slot A, Kroese MC, van Bunningen BN, Ansink AC, van Putten WL, Creutzberg CL; PORTEC Study Group. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet. 2010 Mar 6;375(9717):816-23. doi: 10.1016/S0140-6736(09)62163-2. PubMed 20206777 ↗
  • de Boer SM, Nout RA, Jurgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, Mens JW, Slot A, Stenfert Kroese MC, Oerlemans S, Putter H, Verhoeven-Adema KW, Nijman HW, Creutzberg CL. Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship: Results From the Randomized PORTEC-2 Trial. Int J Radiat Oncol Biol Phys. 2015 Nov 15;93(4):797-809. doi: 10.1016/j.ijrobp.2015.08.023. Epub 2015 Aug 18. PubMed 26530748 ↗

Individual participant data

Plan to share: Yes — After submission of a research plan and approval by the TMG data will be shared

Supporting information: Study protocol, Icf, Csr

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 12, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00376844
Lead sponsor
Leiden University
Collaborators
Dutch Cancer Society
Responsible party
Carien Creutzberg (Professor of Radiation Oncology, Chief investigator, Leiden University Medical Center) — Principal investigator
First posted
Sep 15, 2006
Start date
May 2002
Primary completion
May 2009
Completion
Apr 2016
Last update
Apr 12, 2022

Study contacts

Carien L. Creutzberg, MD, PhD
study chair · Leiden University Medical Center

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Apr 2022. You cannot join it, but the record below documents what was studied.

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