Preliminary results of chemoradiation as a primary treatment for vulvar carcinoma

Old and new perspectives in the management of high-risk, locally advanced or recurrent, and metastatic vulvar cancer

“…Concurrent 5-FU-based chemotherapy is usually given as a 4-day continuous infusion in the first and in the fourth or fifth week of irradiation. Several authors [72,100,[119][120][121][122][123][124][125][126] have employed the regimen 5-FU + CDDP in combination with radiotherapy, whereas concurrent chemoradiation with TAX deserves further clinical investigation [127][128][129]. Data from the literature showed that the clinical complete and overall response rates following combined chemotherapy and radiotherapy ranged from 46.5% to 72.2% and from 81.2% to 100%, respectively [72,[111][112][113][114][115][116][117][119][120][121][122]125].…”

“…Whereas the association of BLEO and irradiation was disappointing [109,110], the use of radiotherapy combined with single-agent 5-FU or 5-FU + MMC [111][112][113][114][115][116][117][118] (Tables 3 and 4) or with 5-FU + CDDP [72,100,[119][120][121][122][123][124][125][126] (Tables 5 and 6) has given promising results. Chemotherapy started at the first day of irradiation and was usually repeated after 4 weeks.…”

“…Akl et al [124] delivered concomitant chemotherapy and irradiation to the vulva only to 12 patients who underwent vulvar biopsies and groin lymph node dissection 4-6 weeks after treatment. All patients achieved a complete response, and after a mean follow-up of 41 months only 2 (16.7%) patients developed a recurrence that was recovered by surgery.…”

Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva

“…A number of retrospective analyses have established the feasibility of this new therapeutic approach, and suggested a therapeutic benefit of induction chemoradiation therapy for the treatment of vulvar neoplasms (2,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The majority of studies involved patients with locally advanced vulvar neoplasms, but certain studies also included recurrent tumor cases that were not eligible for surgical resection by radical vulvectomy.…”

Radiation in vulvar cancer

“…There have been several retrospective analyses that establish the feasibility of, and suggest a therapeutic benefit for, CCRT in LAVC [28][29][30][31]. Many of these trials had mixed groups of patients (primary and recurrent) in which CCRT has been used as preoperative as well as primary therapy and therefore it is difficult to interpret results.…”