Radiotherapy Plus Chemotherapy Is Associated With Improved Survival Compared to Radiotherapy Alone in Patients With Primary Vaginal Carcinoma: A Retrospective SEER Study

Zhou, Weili; Yue, Yangyang

doi:10.3389/fonc.2020.570933

Cited by 4 publications

(5 citation statements)

References 36 publications

(36 reference statements)

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Section: Discussionsupporting

confidence: 93%

“…This study confirmed that older age and larger tumor size were negatively associated with survival, consistent with other studies (4,11,12,(37)(38)(39). We also found that a higher tumor stage was negatively correlated with the survival of VC patients, similar to previous studies (4,17,(38)(39)(40). Instead of using a single FIGO or AJCC stage, we investigated T, N, and M stages in our models because they show a more elaborate representation of tumor progress than a single stage.…”

Section: Discussionsupporting

confidence: 91%

“…Moreover, we discovered that radiotherapy, chemotherapy, and more aggressive surgery were positively correlated with survival, in agreement with other studies (9,11,12,14,(38)(39)(40)(41). Surgery combined with radiotherapy and chemotherapy is still the primary treatment for VC (42).…”

Section: Discussionsupporting

confidence: 90%

See 2 more Smart Citations

Development and validation of models for predicting the overall survival and cancer-specific survival of patients with primary vaginal cancer: A population-based retrospective cohort study

Zhou

Yue

2022

Front. Med.

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BackgroundNo models have been developed to predict the survival probability for women with primary vaginal cancer (VC) due to VC’s extreme rareness. We aimed to develop and validate models to predict the overall survival (OS) and cancer-specific survival (CSS) of VC patients.MethodsA population-based multicenter retrospective cohort study was carried out using the 2004–2018 Surveillance, Epidemiology, and End Results Program database in the United States. The final multivariate Cox model was identified using the Brier score and Harrell’s C concordance statistic (C-statistic). The decision curve, calibration plot, and area under the time-dependent receiver operating characteristic curve (AUC) were used to evaluate model prediction performance. Multiple imputation followed by bootstrap was performed. Bootstrap validation covered the entire statistic procedure from model selection to baseline survival and coefficient calculation. Nomograms predicting OS and CSS were generated.ResultsOf the 2,417 eligible patients, 1,692 and 725 were randomly allocated to the training and validation cohorts. The median age (Interquartile range) was 66 (56–78) and 65 (55–76) for the two cohorts, respectively. Our models had larger net benefits in predicting the survival of VC patients than the American Joint Committee on Cancer stage, presenting great discrimination ability and excellent agreement between the expected and observed events. The performance metrics of our models were calculated in three cohorts: the training cohort, complete cases of the validation cohort, and the imputed validation cohort. For the OS model in the three cohorts, the C-statistics were 0.761, 0.752, and 0.743. The slopes of the calibration plots were 1.017, 1.005, and 0.959. The 3- and 5-year AUCs were 0.795 and 0.810, 0.768 and 0.771, and 0.770 and 0.767, respectively. For the CSS model in the three cohorts, the C-statistics were 0.775, 0.758, and 0.755. The slopes were 1.021, 0.939, and 0.977. And the 3- and 5-year AUCs were 0.797 and 0.793, 0.786 and 0.788, and 0.757 and 0.757, respectively.ConclusionWe were the first to develop and validate exemplary survival prediction models for VC patients and generate corresponding nomograms that allow for individualized survival prediction and could assist clinicians in performing risk-adapted follow-up and treatment.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

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Development and validation of models for predicting the overall survival and cancer-specific survival of patients with primary vaginal cancer: A population-based retrospective cohort study

Zhou

Yue

2022

Front. Med.

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“…Rajagopalan et al 29 and Samant et al 30 reported that concurrent chemoradiation is independently prognostic of improved survival in patients with vaginal cancer. Zhou et al 31 indicated that concurrent chemoradiation is preferrable to radiotherapy alone for patients with vaginal adenocarcinoma with tumor size less than 2 cm, and FIGO Stage I. Radiotherapy (EBRT plus brachytherapy) combined with surgery is one of the currently recommended treatments for vaginal cancer. 8,12 We found that the OS of the radiotherapy combined with surgery group was significantly better than the OS of the other two groups (both P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Prognostic nomogram and treatment efficacy analysis for vaginal cancer: A SEER database and external validation study

Chen

et al. 2023

Intl J Gynecology & Obste

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Objectives To analyze the prognosis and treatment decisions for patients with vaginal cancer through a large retrospective cohort study, in order to assist clinicians to evaluate the condition and choose treatment methods. Methods This was a retrospective study analyzed with Cox regression, nomogram, and external validation. The Kaplan–Meier curve was used for comparative analysis of various treatment modalities. Results A total of 6650 cases of vaginal cancer diagnosed between 2000 and 2018 from the Surveillance, Epidemiology, and End Results database and 106 cases diagnosed between 2006 and 2021 from Fujian Cancer Hospital were identified. Young age, early FIGO (the International Federation of Gynecology and Obstetrics) stage, well‐differentiated, squamous and adenocarcinoma, first primary malignancy, married, undergoing surgery, and chemoradiotherapy were good independent prognostic factors (P < 0.001). The internal and external validation concordance indices were 0.7102 and 0.7785, respectively. The Kaplan–Meier curves indicated that surgery, radiotherapy, and chemotherapy significantly improved survival in patients with vaginal cancer. Forest plots suggest that radiotherapy combined with surgery was superior to radiotherapy alone (P < 0.001). Conclusion We established a specific nomogram to predict vaginal cancer prognosis. Surgery combined with external beam radiation plus brachytherapy may be the most recommended treatment option.

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“…Treatment strategies are often adapted from evidence in locally advanced cervical cancer due to the lack of sufficient clinical evidence. When surgery is not an option, the organ-sparing treatment plan relies on definitive radiotherapy,6 which includes external beam radiotherapy targeting the primary tumor and regional lymph nodes and a boost to the residual tumor with brachytherapy,9 together with concurrent chemotherapy 8 10…”

Section: Introductionmentioning

confidence: 99%

Combined modality including novel sensitizers in gynecological cancers

Zhou

Espenel

Achkar

et al. 2022

Int J Gynecol Cancer

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Standard treatment of locally advanced gynecological cancers relies mainly on platinum-based concurrent chemoradiotherapy followed by brachytherapy. Current chemotherapeutic drugs are only transiently effective and patients with advanced disease often develop resistance and subsequently, distant metastases despite significant initial responses of the primary tumor. In addition, some patients still develop local failure or progression, suggesting that there is still a place for increasing the anti-tumor radiation effect. Several strategies are being developed to increase the probability of curing patients. Vaginal cancer and vulva cancer are rare diseases, which resemble cervical cancer in their histology and pathogenesis. These gynecological cancers are predominantly associated with human papilloma virus infection. Treatment strategies in other unresectable gynecologic cancers are usually derived from evidence in locally advanced cervical cancers. In this review, we discuss mechanisms by which novel therapies could work synergistically with conventional chemoradiotherapy, from pre-clinical and ongoing clinical data. Trimodal, even quadrimodal treatment are currently being tested in clinical trials. Novel combinations derived from a metastatic setting, and being tested in locally advanced tumors, include anti-angiogenic agents, immunotherapy, tumor-infiltrating lymphocytes therapy, adoptive T-cell therapy and apoptosis inducers to enhance chemoradiotherapy efficacy through complementary molecular pathways. In parallel, radiosensitizers, such as nanoparticles and radiosensitizers of hypoxia aim to maximize the effect of radiotherapy locally.

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Radiotherapy Plus Chemotherapy Is Associated With Improved Survival Compared to Radiotherapy Alone in Patients With Primary Vaginal Carcinoma: A Retrospective SEER Study

Cited by 4 publications

References 36 publications

Development and validation of models for predicting the overall survival and cancer-specific survival of patients with primary vaginal cancer: A population-based retrospective cohort study

Development and validation of models for predicting the overall survival and cancer-specific survival of patients with primary vaginal cancer: A population-based retrospective cohort study

Prognostic nomogram and treatment efficacy analysis for vaginal cancer: A SEER database and external validation study

Combined modality including novel sensitizers in gynecological cancers

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