Squamous cell carcinoma of the vagina: natural history, treatment modalities and prognostic factors

Gadducci, Angiolo; Fabrini, Maria Grazia; Lanfredini, Nora; Sergiampietri, Claudia

doi:10.1016/j.critrevonc.2014.09.002

Cited by 70 publications

(83 citation statements)

References 103 publications

(216 reference statements)

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“…Many authors reported that a total dose of RT of at least 70 Gy was a significant factor for predicting good OS [4,6,13]. The patients who underwent EBRT on the entire vagina, the para-vaginal area and pelvic lymph nodes followed by BT boost had a trend for a better OS compared to those who received other treatment modalities (p = 0.084).…”

Section: Discussionmentioning

confidence: 83%

“…RT is the treatment of choice for patients with primary squamous cell carcinoma of the vagina [2,[5][6][7][8][9][10][11][12][13]. Therapy consists of a combination of EBRT and BT depending on the extent, thickness, location and morphology of the tumor.…”

Section: Discussionmentioning

confidence: 99%

“…The total dose of RT should be about 70 Gy, depending on tumor site and extent of disease. Concurrent cisplatin-based chemoradiation (CCRT) has been recently introduced into the treatment of this malignancy [13][14][15][16][17]. The aim of this study was to assess the clinical outcome and survival of patients with squamous cell carcinoma of the vagina treated with definitive RT.…”

Section: Introductionmentioning

confidence: 99%

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Definitive Radiotherapy for Primary Squamous Cell Carcinoma of the Vagina: Are High-Dose External Beam Radiotherapy and High-Dose-Rate Brachytherapy Boost the Best Treatment? Experience of Two Italian Institutes

et al. 2017

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Introduction: We assessed the clinical outcome and survival of 70 patients with primary vaginal squamous cell carcinoma undergoing radiotherapy (RT) at the Divisions of Radiotherapy, University of Pisa and ASST Cremona between January 1995 and June 2016. Methods: 58 patients received external beam RT (EBRT) to the entire vagina, para-vaginal area and pelvic nodes (total dose: 45-50.4 Gy). 29 patients (41.4%) received concomitant weekly cisplatin 40 mg/m². 35 patients received an additional (15-36 Gy) high-dose-rate (HDR) brachytherapy (BT) boost and 13 received an additional (9-25 Gy) EBRT boost to the primary tumor site. 12 women exclusively received HDR-BT up to a total dose of (30-58 Gy). Results: Median overall survival (OS) was 85 months. A total RT dose of > 60 Gy was significantly associated with a better OS (p = 0.015). There was a trend for a better OS for patients aged < 70 years and for those undergoing EBRT to the entire vagina and pelvis plus BT boost. The most common grade 1-2 acute toxicities were diarrhea (24.1%) and cystitis (20.7%); grade 3 cystitis only occurred in 2 patients (3.4%). Conclusions: EBRT followed by BT boost seems to be the best treatment for vaginal carcinoma. The total dose of RT should be > 60 Gy.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Definitive Radiotherapy for Primary Squamous Cell Carcinoma of the Vagina: Are High-Dose External Beam Radiotherapy and High-Dose-Rate Brachytherapy Boost the Best Treatment? Experience of Two Italian Institutes

et al. 2017

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“…The main determinant of prognoses in carcinoma of the vagina is the stage of disease at the time of diagnosis, independently of subjacent histology. Additional factors influencing prognosis in squamous subtype are the tumor volume (>4 cm), its location outside of the upper third of the vagina, HPV status, and MIB‐1 index . As with other malignancies, age, reproductive and sexual functions, and performance status can influence the selection of specific therapies and potentially affect survival outcomes.…”

Section: Prognoses and Outcomes Of Vaginal Cancermentioning

confidence: 99%

“…This is particularly useful in the management of large volume tumors (particularly ≥4 cm) minimizing grade 3-4 toxicities. 37Confirming such an improvement, a recent review from Gadducci et al54 summarized the data available and obtained a five-year overall survival that varies between 35% and 78%, with a severe late complication rate between 9.4% and 23.1% among cases of squamous carcinoma of the vagina when treated with different standards of radiotherapy.…”

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confidence: 99%

Cancer of the vagina

Adams

Cuello

2018

Intl J Gynecology & Obste

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Diagnosis of a primary vaginal cancer is rare because most of these lesions will be metastatic from another primary site. Although cancer of the vagina is more common in postmenopausal women, an increase in young women being diagnosed with primary vaginal cancer has been reported, especially in countries with a high HIV prevalence. This will be associated with persistence of high‐risk HPV infection. The emphasis should be on primary prevention with prophylactic HPV vaccination. Once there is a suspicion of a primary vaginal cancer, this should be confirmed histologically with biopsy. Staging has been done clinically, similar to cervical cancer; however, there is a role for imaging in assisting with staging as this is often a difficult assessment. Treatment should be individualized and depends on stage as well as histologic subtype. It is prudent to refer cases to centers of excellence with experience in dealing with this rare gynecological cancer.

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Tumors of the Vulva and Vagina

Broach

Leitao

2017

Textbook of Uncommon Cancer

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Squamous cell carcinoma of the vagina: natural history, treatment modalities and prognostic factors

Cited by 70 publications

References 103 publications

Definitive Radiotherapy for Primary Squamous Cell Carcinoma of the Vagina: Are High-Dose External Beam Radiotherapy and High-Dose-Rate Brachytherapy Boost the Best Treatment? Experience of Two Italian Institutes

Definitive Radiotherapy for Primary Squamous Cell Carcinoma of the Vagina: Are High-Dose External Beam Radiotherapy and High-Dose-Rate Brachytherapy Boost the Best Treatment? Experience of Two Italian Institutes

Cancer of the vagina

Tumors of the Vulva and Vagina

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