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Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy.

Lee J, Kim SH, Kim G, Yu M, Park DC, Yoon JH, Yoon SC - Radiat Oncol J (2012)

Bottom Line: Response rate was 55% (11/20).Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications.One patient died of sepsis from lymphedema.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.

ABSTRACT

Purpose: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy.

Materials and methods: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy.

Results: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications.

Conclusion: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

No MeSH data available.


Related in: MedlinePlus

Overall survival of patients with vulvar cancer according to treatment response. PR, partial reponse; SD, stable disease; PD, progressed disease.
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Figure 2: Overall survival of patients with vulvar cancer according to treatment response. PR, partial reponse; SD, stable disease; PD, progressed disease.

Mentions: Table 3 shows both treatment outcome and pattern of failure in 20 patients with vulvar cancer. Four patients were excluded for response evaluation because of 3 losses of follow up and 1 death at 2 weeks after radiotherapy. Eleven patients achieved CR, 4 patients achieved PR, and 5 patients developed stable disease (SD) or progression of disease (PD). Among the patients with CR, more than half of them (7/11) were treated with radical surgery and postoperative radiotherapy. Response rate was 55% (11/20) and was 75% (15/20) if included partial response. Eight of twenty patients showed recurrent disease after radiotherapy. Six of them developed locoregional recurrence. Two Patients treated with palliative radiotherapy developed both locoregional recurrence and distant metastasis. Among the patients with good treatment response (more than PR, 15 patients), 2 patients developed vulvar recurrence and 1 patient developed inguinal node recurrence. The 2-year OS was 72.6% and 5-year OS was 46.2%, respectively (Fig. 1A). The 2-year DFS was 63.2% and 5-year DFS was 42.2%, respectively (Fig. 1B). The 2-year OS of good response group (≥PR) was 93.3% but 2-year OS of the others (SD + PD) was 31.3% (p = 0.0009) (Fig. 2). The median survival of patients with good response was 73 months but that was 13 months in patients with stable or progression of disease.


Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy.

Lee J, Kim SH, Kim G, Yu M, Park DC, Yoon JH, Yoon SC - Radiat Oncol J (2012)

Overall survival of patients with vulvar cancer according to treatment response. PR, partial reponse; SD, stable disease; PD, progressed disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3475959&req=5

Figure 2: Overall survival of patients with vulvar cancer according to treatment response. PR, partial reponse; SD, stable disease; PD, progressed disease.
Mentions: Table 3 shows both treatment outcome and pattern of failure in 20 patients with vulvar cancer. Four patients were excluded for response evaluation because of 3 losses of follow up and 1 death at 2 weeks after radiotherapy. Eleven patients achieved CR, 4 patients achieved PR, and 5 patients developed stable disease (SD) or progression of disease (PD). Among the patients with CR, more than half of them (7/11) were treated with radical surgery and postoperative radiotherapy. Response rate was 55% (11/20) and was 75% (15/20) if included partial response. Eight of twenty patients showed recurrent disease after radiotherapy. Six of them developed locoregional recurrence. Two Patients treated with palliative radiotherapy developed both locoregional recurrence and distant metastasis. Among the patients with good treatment response (more than PR, 15 patients), 2 patients developed vulvar recurrence and 1 patient developed inguinal node recurrence. The 2-year OS was 72.6% and 5-year OS was 46.2%, respectively (Fig. 1A). The 2-year DFS was 63.2% and 5-year DFS was 42.2%, respectively (Fig. 1B). The 2-year OS of good response group (≥PR) was 93.3% but 2-year OS of the others (SD + PD) was 31.3% (p = 0.0009) (Fig. 2). The median survival of patients with good response was 73 months but that was 13 months in patients with stable or progression of disease.

Bottom Line: Response rate was 55% (11/20).Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications.One patient died of sepsis from lymphedema.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.

ABSTRACT

Purpose: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy.

Materials and methods: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy.

Results: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications.

Conclusion: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

No MeSH data available.


Related in: MedlinePlus