What is the role of EBRT/brachytherapy (as an addition to chemotherapy) in the adjuvant management of optimally debulked stage IV uterine serous carcinoma?  

NCCN guidelines mention EBRT/vaginal brachytherapy as options in addition to chemotherapy in the adjuvant setting for high grade histologies, stages 1B-4. The recommendation is mostly based on retrospective studies that showed benefit with improvement in PFS and OS. However, strategies on how to select the optimal patient from within this large category are unclear. While the NCCN states this is an area of active investigation through the PORTEC-3 and GOG-258 trials, what information can we use to guide current practice patterns?