Radiation Oncology Journal

  • 제30권1호
  • /
  • Pages.20-26
  • /
  • 2012
  • /
  • 2234-1900(pISSN)
  • /
  • 2234-3156(eISSN)
대한방사선종양학회 (The Korean Society for Radiation Oncology)
권호 표지
DOI QR코드

DOI QR Code

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

  • Lee, Ja-Young (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine) ;
  • Kim, Sung-Hwan (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine) ;
  • Kim, Gi-Won (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine) ;
  • Yu, Mi-Na (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Park, Dong-Choon (Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine) ;
  • Yoon, Joo-Hee (Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine) ;
  • Yoon, Sei-Chul (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine)
  • 투고 : 2012.02.29
  • 심사 : 2012.03.21
  • 발행 : 2012.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. Materials and Methods: The 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. Results: Twenty 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. Conclusion: Outcome 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.

키워드

참고문헌

  1. Jung KW, Park S, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2008. Cancer Res Treat 2011;43:1-11. https://doi.org/10.4143/crt.2011.43.1.1
  2. Lin JY, DuBeshter B, Angel C, Dvoretsky PM. Morbidity and recurrence with modifications of radical vulvectomy and groin dissection. Gynecol Oncol 1992;47:80-6. https://doi.org/10.1016/0090-8258(92)90081-S
  3. Gould N, Kamelle S, Tillmanns T, et al. Predictors of complications after inguinal lymphadenectomy. Gynecol Oncol 2001;82:329-32. https://doi.org/10.1006/gyno.2001.6266
  4. Moore DH. Chemotherapy and radiation therapy in the treatment of squamous cell carcinoma of the vulva: are two therapies better than one? Gynecol Oncol 2009;113:379-83. https://doi.org/10.1016/j.ygyno.2009.01.004
  5. Crosbie EJ, Slade RJ, Ahmed AS. The management of vulval cancer. Cancer Treat Rev 2009;35:533-9. https://doi.org/10.1016/j.ctrv.2009.01.005
  6. Wahlen SA, Slater JD, Wagner RJ, et al. Concurrent radiation therapy and chemotherapy in the treatment of primary squamous cell carcinoma of the vulva. Cancer 1995;75:2289-94. https://doi.org/10.1002/1097-0142(19950501)75:9<2289::AID-CNCR2820750917>3.0.CO;2-4
  7. Katz A, Eifel PJ, Jhingran A, Levenback CF. The role of radiation therapy in preventing regional recurrences of invasive squamous cell carcinoma of the vulva. Int J Radiat Oncol Biol Phys 2003;57:409-18. https://doi.org/10.1016/S0360-3016(03)00591-1
  8. Barton DP. The prevention and management of treatment related morbidity in vulval cancer. Best Pract Res Clin Obstet Gynaecol 2003;17:683-701. https://doi.org/10.1016/S1521-6934(03)00045-2
  9. Landoni F, Maneo A, Zanetta G, et al. Concurrent preoperative chemotherapy with 5-fluorouracil and mitomycin C and radiotherapy (FUMIR) followed by limited surgery in locally advanced and recurrent vulvar carcinoma. Gynecol Oncol 1996;61:321-7. https://doi.org/10.1006/gyno.1996.0150
  10. Gerszten K, Selvaraj RN, Kelley J, Faul C. Preoperative chemoradiation for locally advanced carcinoma of the vulva. Gynecol Oncol 2005;99:640-4. https://doi.org/10.1016/j.ygyno.2005.07.126
  11. Lupi G, Raspagliesi F, Zucali R, et al. Combined preoperative chemoradiotherapy followed by radical surgery in loc ally advanced vulvar carcinoma: a pilot study. Cancer 1996;77:1472-8. https://doi.org/10.1002/(SICI)1097-0142(19960415)77:8<1472::AID-CNCR8>3.0.CO;2-E
  12. Homesley HD, Bundy BN, Sedlis A, et al. Assessment of current International Federation of Gynecology and Obstetrics staging of vulvar carcinoma relative to prognostic factors for survival (a Gynecologic Oncology Group study). Am J Obstet Gynecol 1991;164:997-1003. https://doi.org/10.1016/0002-9378(91)90573-A
  13. Landrum LM, Skaggs V, Gould N, Walker JL, McMeekin DS. Comparison of outcome measures in patients with advanced squamous cell carcinoma of the vulva treated with surgery or primary chemoradiation. Gynecol Oncol 2008;108:584-90. https://doi.org/10.1016/j.ygyno.2007.11.010
  14. Moore DH, Thomas GM, Montana GS, Saxer A, Gallup DG, Olt G. Preoperative chemoradiation for advanced vulvar cancer: a phase II study of the Gynecologic Oncology Group. Int J Radiat Oncol Biol Phys 1998;42:79-85. https://doi.org/10.1016/S0360-3016(98)00193-X
  15. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995;31:1341-6. https://doi.org/10.1016/0360-3016(95)00060-C
  16. Kunos C, Simpkins F, Gibbons H, Tian C, Homesley H. Radiation therapy compared with pelvic node resection for nodepositive vulvar cancer: a randomized controlled trial. Obstet Gynecol 2009;114:537-46. https://doi.org/10.1097/AOG.0b013e3181b12f99
  17. Jang WI, Wu HG, Park CI, et al. Management of regional lymph nodes in localized vulvar carcinoma. J Korean Soc Ther Radiol Oncol 2008;26:1-9. https://doi.org/10.3857/jkstro.2008.26.1.1
  18. Van der Zee AG, Oonk MH, De Hullu JA, et al. Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol 2008;26:884-9. https://doi.org/10.1200/JCO.2007.14.0566
  19. Beriwal S, Coon D, Heron DE, et al. Preoperative intensitymodulated radiotherapy and chemotherapy for locally advanced vulvar carcinoma. Gynecol Oncol 2008;109:291-5. https://doi.org/10.1016/j.ygyno.2007.10.026
  20. Montana GS, Thomas GM, Moore DH, et al. Preoperative chemo-radiation for carcinoma of the vulva with N2/N3 nodes: a gynecologic oncology group study. Int J Radiat Oncol Biol Phys 2000;48:1007-13. https://doi.org/10.1016/S0360-3016(00)00762-8
  21. Stroup AM, Harlan LC, Trimble EL. Demographic, clinical, and treatment trends among women diagnosed with vulvar cancer in the United States. Gynecol Oncol 2008;108:577-83. https://doi.org/10.1016/j.ygyno.2007.11.011
  22. Talaat A, Brinkmann D, Nagar Y, Hogston P, Khoury G, Woolas R. Experience in the management of patients older than 80 years with vulval cancer. Int J Gynecol Cancer 2009;19:752-5. https://doi.org/10.1111/IGC.0b013e31819d7d31
  23. Hou JL, Wu LY, Zhang HT, Lv NN, Huang Y, Yu GZ. Clinicopathologic characteristics of 12 patients with vulvar sweat gland carcinoma. Int J Gynecol Cancer 2010;20:874-8. https://doi.org/10.1111/IGC.0b013e3181e1c167
  24. Tans L, Ansink AC, van Rooij PH, Kleijnen C, Mens JW. The role of chemo-radiotherapy in the management of locally advanced carcinoma of the vulva: single institutional experience and review of literature. Am J Clin Oncol 2011;34:22-6. https://doi.org/10.1097/COC.0b013e3181cae6a1

피인용 문헌

  1. Treatment outcomes of curative radiotherapy in patients with vulvar cancer: results of the retrospective KROG 1203 study vol.33, pp.3, 2012, https://doi.org/10.3857/roj.2015.33.3.198
  2. Vulvar cancer in Tunisia: Epidemiological and clinicopathological features multicentric study vol.29, pp.2, 2017, https://doi.org/10.1016/j.jnci.2017.02.001
  3. A phase 2 study of combined chemo-immunotherapy with cisplatin-pembrolizumab and radiation for unresectable vulvar squamous cell carcinoma vol.18, pp.1, 2012, https://doi.org/10.1186/s12967-020-02523-5