Definitive radiotherapy for treatment of primary vaginal cancer: effectiveness and prognostic factors.

Abstract

OBJECTIVE:

This study was performed to evaluate treatment outcomes and define prognostic factors for primary vaginal cancer treated with definitive radiotherapy.

MATERIALS AND METHODS:

We retrospectively analyzed 38 patients with primary vaginal cancer who received radiotherapy with curative intent between January 1981 and August 2008. Of these 38 patients, 6 were excluded from this analysis because of other uncontrolled malignancy (n = 1), uncommon histology (n = 4), or insufficient medical records (n = 1). Twenty-three patients (72%) presented with early-stage disease (International Federation of Gynecology and Obstetrics stages 0, I, or II). Eleven patients (34%) were treated with external beam radiotherapy (EBRT) alone and 21 patients (66%) with EBRT plus brachytherapy (BT). Low-dose rate cesium-137 was used with intracavitary technique for most of the patients who received BT. Five patients received chemotherapy. The median total dose in patients who received EBRT and EBRT+BT was 50.4 Gy (range, 39.6-70.4 Gy) and 78.9 Gy (range, 72.0-87.0 Gy), respectively.

RESULTS:

The median duration of follow-up was 38 months. Five-year overall survival, cause-specific survival, disease-free survival, local control, and regional control rates for the analyzed patients were 75%, 88%, 58%, 62% and 90%, respectively. Thirteen patients had treatment failure as follows: local (n = 7), distant (n = 1), local plus regional (n = 1), local plus distant (n = 2), and local plus regional plus distant (n = 2). Primary tumor size was a significant prognostic factor for disease-free survival (P = 0.039).

CONCLUSIONS:

Definitive radiotherapy is an effective treatment modality for primary vaginal cancer. Local failure was the major failure pattern, and achievement of local control is important for disease control and survival.

• Authors: Won Il Jang, Hong-Gyun Wu, Sung Whan Ha, Hak Jae Kim, Soon Beom Kang, Yong Sang Song, Noh-Hyun Park, Jae Weon Kim
• Journal: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society (Int J Gynecol Cancer) Vol. 22 Issue 3 Pg. 521-7 (Mar 2012) ISSN: 1525-1438 [Electronic] England
• PMID: 22367326 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (analysis)
• Carcinoma (diagnosis, mortality, radiotherapy)
• Female
• Follow-Up Studies
• Humans
• Middle Aged
• Prognosis
• Remission Induction (methods)
• Retrospective Studies
• Survival Analysis
• Treatment Outcome
• Vaginal Neoplasms (diagnosis, mortality, radiotherapy)