Definitive radiotherapy for primary vaginal cancer: correlation between treatment patterns and recurrence rate.
Bottom Line: In Federation of Gynecology and Obstetrics (FIGO) Stage I cases, 3 of 8 patients (38%) who did not undergo prophylactic lymph node irradiation had lymph node recurrence, compared with 2 of 12 patients (17%) who underwent prophylactic pelvic irradiation.Patients with FIGO Stage I/II or clinical Stage N1 had a higher recurrence rate with treatment using a single modality compared with the recurrence rate using combined modalities.Improvement of treatment outcomes in cases of FIGO Stage III or IV remains a significant challenge.
Affiliation: Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 (D10) Yamadaoka, Suita, Osaka 565-0871, Japan Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, Osaka 537-8511, Japan.Show MeSH
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Mentions: At the time of analysis, the median follow-up time of the 49 patients was 33 months (range: 1–169 months). The 3-year OS, DFS and LRC rates were 83%, 59% and 71%, respectively (Fig. 1A). According to FIGO stage, the 3-year OS for Stages I, II and III–IV patients was 81%, 86% and 83%, respectively (Fig. 1B), and the corresponding 3-year DFS was 60%, 65% and 40%, respectively (Fig. 1C). Relationships among outcomes, tumor types, and treatment factors are summarized in Table 2. The histological type (P = 0.037) and FIGO stage (P = 0.026) were significantly associated with DFS; and histological type (P = 0.028), FIGO stage (P = 0.019), and clinical N stage (P = 0.023) were significantly associated with LRC. In patients treated with brachytherapy, LRC did not differ significantly between patients treated with ISBT and ICBT. Multivariate analysis was performed with histological type (SCC vs others), FIGO stage (I/II vs III/IV) and clinical N stage (N0 vs N1), which were judged to be potential risk factors in univariate analysis. In multivariate analysis, the histological type (HR = 3.82, 95% CI = 1.04–13.08, P = 0.044) was a significant risk factor for LRC. OS showed no significant differences between different tumor types and treatment factors.Table 2.
Affiliation: Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 (D10) Yamadaoka, Suita, Osaka 565-0871, Japan Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, Osaka 537-8511, Japan.