The Role of Chemo-Radiotherapy in the Management of Locally Advanced Carcinoma of the Vulva

Tans, Lisa; Ansink, Anca C.; Rooij, Peter H. van; Kleijnen, Carin; Mens, Jan Willem M.

doi:10.1097/coc.0b013e3181cae6a1

Cited by 46 publications

(24 citation statements)

References 20 publications

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“…A total of 37 of the included 58 patients (63.8%) showed complete clinical response and in 29 patients (50%) complete pathologic remission could be achieved with acceptable toxicity [Moore et al 2012]. Following these encouraging results, weekly cisplatin should be applied for chemoradiation although mitomycin C and 5-flurouracil might be serve as alternative regimens (complete response rates of 30-70%) in the case of contraindications for cisplatin [Tans et al 2010].…”

Section: Radiotherapy or Chemoradiation In Advanced Vulvar Cancermentioning

confidence: 94%

Management of patients with vulvar cancer: a perspective review according to tumour stage

et al. 2013

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Treatment of patients with vulvar cancer is challenging for gynaecologic oncologists. Owing to the localization in a sensitive area, surgical radicality and the indication for adjuvant treatment have to be balanced with psychosocial aspects to treat patients adequately. Clinical management is therefore highly dependent on the tumour stage. For patients with early-stage disease (FIGO I-II) therapy mainly concentrates on surgery with resection of the primary tumour and staging of the groin lymph nodes. In intermediate-stage vulvar cancer (FIGO III), advanced disease is expressed by affected inguinofemoral lymph nodes bringing radical lymphadenectomy and adjuvant therapy as well as radiation or chemoradiation into the focus of treatment. For locally advanced or metastatic vulvar cancer (FIGO IV) neoadjuvant or definitive chemoradiation has to be considered besides surgery. Owing to the low incidence of the disease, the level of evidence for different treatment modalities is poor. This review therefore puts different recommendations of clinical management in context and highlights the need for future trials.

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Section: Radiotherapy or Chemoradiation In Advanced Vulvar Cancermentioning

confidence: 94%

Management of patients with vulvar cancer: a perspective review according to tumour stage

et al. 2013

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“…Numbers of patients in each characteristic group are too small to attain statistical power. Numerous previous studies for vulvar cancer also had similar limitations [7,22-24]. Because of these limitations of this study all results should be interpreted with caution and serve mainly to help identify issue requiring prospective trials rather than to provide evidence based answers.…”

Section: Discussionmentioning

confidence: 84%

Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

Lee

Kim

et al. 2012

Radiat Oncol J

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PurposeTo evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy.Materials and MethodsThe records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy.ResultsTwenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications.ConclusionOutcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

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“…In advanced cases, neoadjuvant chemotherapy is a beneficial option if surgery can be performed thereafter 25. The combination of chemotherapy and radiation is an option for patients where surgery is impossible 26,27. In our cases, vulvectomy is planned for case 1 and combined chemoradiotherapy after debulking surgery is planned for case 2.…”

Section: Discussionmentioning

confidence: 99%

Condyloma-like squamous cell carcinoma of the vulva: report of two midline cases

Verma¹,

Wollina²

2012

CCID

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The Role of Chemo-Radiotherapy in the Management of Locally Advanced Carcinoma of the Vulva

Abstract: These data support the use of concurrent chemoradiotherapy as an effective alternative to primary ultra-radical surgery to treat LAVC with an acceptable toxicity profile.

Cited by 46 publications

References 20 publications

Management of patients with vulvar cancer: a perspective review according to tumour stage

Management of patients with vulvar cancer: a perspective review according to tumour stage

Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

Condyloma-like squamous cell carcinoma of the vulva: report of two midline cases

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