NDLI: The role of chemo-radiotherapy in the management of locally advanced carcinoma of the vulva: single institutional experience and review of literature.

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The role of chemo-radiotherapy in the management of locally advanced carcinoma of the vulva: single institutional experience and review of literature.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Tans, Lisa Ansink, Anca C. Van Rooij, Peter H. Kleijnen, Carin Mens, Jan W.
Description	Country affiliation: Netherlands Author Affiliation: Tans L ( Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. l.tans@erasmusmc.nl)
Abstract	OBJECTIVE: To retrospectively investigate the outcome and toxicity of concurrent chemo-radiotherapy in the treatment of locally advanced vulvar cancer (LAVC). PATIENTS AND METHODS: Between 1996 and 2007, 28 consecutive patients with LAVC were treated with chemoradiation (20 primary tumors and 8 loco-regional recurrences). Treatment consists of 2 separate courses of external-beam radiotherapy (40 Gy-2 weeks split-20 Gy). During each course of radiotherapy, 5-fluorouracil (1000 mg/m/d), was given as a continuous intravenous infusion over the first 4 days, and mitomycin-C (10 mg/m on day 1), as a bolus intravenous injection. Outcome measures were rates of complete and partial response, loco-regional control, progression-free survival, overall survival, and toxicity. RESULTS: The median follow-up was 42 months and the median age of patients was 68 years. Twenty patients (72%) achieved complete remission, 4 patients (14%) partial remission, for an overall response rate of 86%. Four patients (14%) had progressive disease directly after chemo-radiotherapy. The actuarial rates of loco-regional control, progression-free survival and overall survival at 4 years were 75%, 71%, and 65%, respectively. There was no treatment break for acute toxicity. Vulvar desquamation was the main acute treatment-related side effect (93%). Three patients developed transient grade 2 neutropenia or thrombocytopenia. Mild skin fibrosis and atrophy (n = 6, 21%), radiation ulcer (n = 4, 14%, in one patient treatment was needed), telangectasia (n = 3, 11%), and lymphoedema (n = 2, 7%) were the most common late toxicity of chemoradiation. CONCLUSION: 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.
File Format	HTM / HTML
ISSN	02773732
Issue Number	1
Volume Number	34
e-ISSN	1537453X
Journal	American Journal of Clinical Oncology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2011-02-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline Oncology Antineoplastic Combined Chemotherapy Protocols Therapeutic Use Neoplasm Recurrence, Local Drug Therapy Radiotherapy Vulvar Neoplasms Adult Aged Aged, 80 And Over Combined Modality Therapy Female Fluorouracil Administration & Dosage Follow-up Studies Humans Middle Aged Mitomycin Pathology Neoplasm Staging Retrospective Studies Survival Rate Treatment Outcome Clinical Trial Journal Article
Content Type	Text
Resource Type	Article
Subject Domain (in MeSH)	Eukaryota Neoplasms Organic Chemicals Heterocyclic Compounds Diagnosis Therapeutics Investigative Techniques Persons
Subject	Oncology Cancer Research

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