Definitive Radiotherapy in Invasive Vaginal Carcinoma: A Systematic Review

Abstract

Only retrospective studies, in a limited number, have been published on RT in VC in the past decade, with significant heterogeneity in terms of treatment characteristic and evaluation criteria. Clinical results were strongly influenced by tumor stage. Prospective randomized studies are needed to improve patients' outcomes, especially in advanced-stage disease.;23:1-10 IMPLICATIONS FOR PRACTICE: This study systematically reviews the recent literature on the role of definitive radiotherapy in the management of vaginal cancer and presents comprehensive data on clinical outcome and toxicity. The prognosis of patients is dismal, with a 5-year overall survival of approximately 50%. Early stage of the disease, small tumor size, previous hysterectomy, high pretreatment/treatment hemoglobin levels, and patients' age were correlated with a better clinical outcome. A brachytherapy boost should be delivered, especially in patients with higher-stage disease. The addition of concurrent weekly cisplatin should be considered in most patients, and transfusion should be used to maintain high hemoglobin levels.

Primary vaginal cancer after hysterectomy for benign conditions: a systematic review of the literature

“…However, a significant portion of the population required adjuvant radiation therapy after surgery ( 34 ). Radiotherapy using external beam and/or brachytherapy is a standard treatment for vaginal cancer, especially in cases that are locally advanced ( 1 , 31 , 34 , 35 ). The principal advantage of radiation is organ preservation.…”

“…The principal advantage of radiation is organ preservation. A systematic review conducted by Guerri et al reported that factors associated with better outcomes in the radiotherapy group included early stage of disease, small tumor size (<4 cm), previous hysterectomy, high pre-treatment hemoglobin levels and younger age (35). Another two retrospective studies demonstrated excellent outcomes with definitive radiotherapy, either with external-beam radiation therapy alone or in combination with brachytherapy.…”

Diagnostic benefit of cytological and histopathological examinations for recurrent vaginal cancer metastasizing to the duodenum: A case report

“…Intensity‐modulated radiation therapy can deliver high dosages of radiation to the cancer, and concurrent chemotherapy is thought to improve patient outcomes. Guerri et al reported five‐year overall survival rates of 35%‐78%, with severe late complication rates of 9%–23% for patients with SCC treated by radiotherapy 10 . Although no data from prospective trials are available, Miyamoto and Viswanathan reviewed retrospective studies and reported that chemoradiation therapy provided significantly better overall survival and disease‐free survival compared with radiation alone (respective three‐year overall survival rates of 79% versus 56% and three‐year disease‐free survival rates of 73% vs 43%) 11 .…”

“…Guerri et al reported five-year overall survival rates of 35%-78%, with severe late complication rates of 9%-23% for patients with SCC treated by radiotherapy. 10 Although no data from prospective trials are available, Miyamoto and Viswanathan reviewed retrospective studies and reported that chemoradiation therapy provided significantly better overall survival and disease-free survival compared with radiation alone (respective threeyear overall survival rates of 79% versus 56% and threeyear disease-free survival rates of 73% vs 43%). 11 Nashiro et al claimed that chemoradiation therapy was effective for primary vaginal SCC and should be considered for patients with high-risk disease.…”

Results of a Phase I-II Study on Laser Therapy for Vaginal Side Effects after Radiotherapy for Cancer of Uterine Cervix or Endometrium

“…Radiotherapy (RT) represents a cornerstone in the treatment of gynecological tumors and, in cases of advanced cervical cancers, it is the only available therapy with curative intent [1][2][3][4][5][6]. However, some side effects affecting sexual function are well known.…”