Outcomes of Definitive Radiation Therapy for Primary Vaginal Carcinoma.

Abstract

OBJECTIVE(S):

The aim of this study was to review treatment and outcomes of patients with primary vaginal cancer treated with definitive radiotherapy.

MATERIALS AND METHODS:

We retrospectively reviewed medical records of 71 patients with primary vaginal adenocarcinoma or squamous cell carcinoma treated with definitive radiotherapy with at least 2 years of follow-up (median follow-up, 6.24 y).

RESULTS:

Ninety-three percent of patients were treated with external-beam radiotherapy plus brachytherapy (median dose, 7540 cGy); 4 patients with stage I disease and 1 patient with stage II disease were treated with brachytherapy alone (median dose, 6000 cGy). The cause-specific 5- and 10-year survival rates, respectively, were 96% and 96% for stage I patients, 75% and 68% for stage II patients, 69% and 64% for stage III patients, and 53% and 53% for stage IVA patients. The 5- and 10-year local-regional control rates for all patients were 79% and 75%, respectively. The 5- and 10-year distant metastasis-free survival rates for all patients were 87% and 85%, respectively. Sixteen patients had tumors involving the distal one third of the vagina. Of the 7 who received elective inguinal node irradiation, 0 failed in the inguinal nodes. Of the 9 who did not receive elective inguinal node irradiation, 2 failed in the inguinal nodes. Severe complications (grades 3 to 4) occurred in 16 patients (23%).

CONCLUSIONS:

Radiotherapy provides excellent results as definitive treatment for primary vaginal cancer, although the risk of severe complications is high. Generally, treatment should consist of both external-beam radiation therapy and brachytherapy. Inguinal nodes should be irradiated electively when the primary tumor involves the distal one third of the vagina.

• Authors: Julie C Greenwalt, Robert J Amdur, Christopher G Morris, Linda S Morgan, Jacqueline Castagno, Merry Jennifer Markham, Shayna Rich, Anamaria R Yeung
• Journal: American journal of clinical oncology (Am J Clin Oncol) Vol. 38 Issue 6 Pg. 583-7 (Dec 2015) ISSN: 1537-453X [Electronic] United States
• PMID: 24136141 (Publication Type: Clinical Study, Journal Article)

Topics

• Adenocarcinoma (pathology, radiotherapy)
• Adult
• Aged
• Aged, 80 and over
• Brachytherapy (methods)
• Carcinoma, Squamous Cell (pathology, radiotherapy)
• Cohort Studies
• Disease-Free Survival
• Female
• Groin
• Humans
• Kaplan-Meier Estimate
• Lymph Nodes (pathology)
• Middle Aged
• Neoplasm Staging
• Radiotherapy (methods)
• Retrospective Studies
• Survival Rate
• Treatment Outcome
• Vaginal Neoplasms (pathology, radiotherapy)