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CC BY-NC-ND 4.0 · South Asian J Cancer 2019; 08(01): 41-43
DOI: 10.4103/sajc.sajc_66_17
ORIGINAL ARTICLE: Gynaecologic Cancers

Conventional radiotherapy and intensity-modulated radiotherapy in carcinoma vulva: An experience from a tertiary medical center of India

Koustav Mazumder
Department of Radiotherapy and Oncology, Postgraduate Medical Education and Research, Chandigarh
,
Arun Elangovan
Department of Radiotherapy and Oncology, Postgraduate Medical Education and Research, Chandigarh
,
Bhavana Rai
Department of Radiotherapy and Oncology, Postgraduate Medical Education and Research, Chandigarh
,
Vanita Suri
Department of Gynecology and obstetrics, Postgraduate Medical Education and Research, Chandigarh
,
Vanita Jain
Department of Gynecology and obstetrics, Postgraduate Medical Education and Research, Chandigarh
,
Jaswinder Kalra
Department of Gynecology and obstetrics, Postgraduate Medical Education and Research, Chandigarh
,
Sushmita Ghoshal
Department of Radiotherapy and Oncology, Postgraduate Medical Education and Research, Chandigarh
› Institutsangaben Financial support and sponsorship: Nil.
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Abstract

Context: Vulvar cancer is one of the uncommon gynecological malignancies. Multimodality treatment with surgery, radiotherapy, and chemotherapy are required for treatment of the disease. Aims: The aim of the study was to evaluate clinical outcome in patients of carcinoma vulva, treated at our institution. Subjects and Methods: This was a retrospective-cohort study done in 50 patients with squamous cell carcinoma of the vulva, treated at our institution from January 2008 to December 2014. Data were analyzed on the basis of age, stage, type of treatment received, and treatment-related toxicity. Disease-free survival and overall survival were estimated. Statistical Analysis Used: Kaplan–Meier survival analysis and Chi-square test were used for statistical analysis. Results: Majority of the patients (52%) had presented with Stage III disease. Thirty-six of 50 patients underwent surgery: simple vulvectomy – 2, radical vulvectomy – 34, bilateral inguinal lymph node dissection was done in 32 patients, and 1 patient underwent ipsilateral-inguinal lymph node dissection. Among 40 patients who received radiotherapy and eight patients received palliative radiotherapy. Seventeen patients underwent intensity-modulated radiotherapy (IMRT) and 15 patients received conventional radiotherapy. Significantly less Grade 2 or more skin toxicity (P = 0.003) observed in patients who underwent IMRT. Among non-IMRT group, eight patients required treatment break during radiation. At a median follow-up time of 25.5 months, median overall survival was 31 months and median disease-free survival was 25 months. About 42% patients were alive and free of disease at last follow-up. Conclusions: Modified radical vulvectomy with inguinal lymph node dissection followed by radiotherapy is the mainstay of management of locally advanced carcinoma vulva. Using IMRT, we could minimize the treatment related radiation toxicity and treatment breaks.

Key words

Radiotherapy - cancer - vulva


Publikationsverlauf

Artikel online veröffentlicht:
21. Dezember 2020

© 2019. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Bailey C, Luesley D. Squamous vulval cancer-an update. The Obstetrician & Gynaecologist 2013;15:227-31
  • 2 Alkatout I, Schubert M, Garbrecht N, Weigel MT, Jonat W, Mundhenke C, et al. Vulvar cancer: Epidemiology, clinical presentation, and management options. Int J Womens Health 2015;7:305-13.
  • 3 Taussig FJ. Cancer of the vulva. Am J Obstet Gynecol 1940;40:764.
  • 4 Homesley HD, Bundy BN, Sedlis A, Yordan E, Berek JS, Jahshan A, et al. Prognostic factors for groin node metastasis in squamous cell carcinoma of the vulva (a gynecologic oncology group study) Gynecol Oncol 1993;49:279-83.
  • 5 Bafna UD, Devi UM, Naik KA, Hazra S, Sushma N, Babu N, et al. Carcinoma of the vulva: A retrospective review of 37 cases at a regional cancer centre in South India. J Obstet Gynaecol 2004;24:403-7.
  • 6 Bailey C, Luesley D. Squamous vulval cancer-an update. The Obstetrician & Gynaecologist 2013;15:227-31. Available from: http://www.seer.cancer.gov/statfacts/html/vulva.html. [Last accessed on 2018 Nov 08].
  • 7 Way S. The anatomy of the lymphatic drainage of the vulva and its influence on the radical operation for carcinoma. Ann R Coll Surg Engl 1948;3:187-209.
  • 8 Hacker NF, Leuchter RS, Berek JS, Castaldo TW, Lagasse LD. Radical vulvectomy and bilateral inguinal lymphadenectomy through separate groin incisions. Obstet Gynecol 1981;58:574-9.
  • 9 Montana GS, Kang SK. Chapter 72 : Carcinoma of the Vulva. In: Perez CA, Brady LW, editor. Principles and Practice of Radiation Oncology, 5th Edition. Philadelphia: Lippincott Williams & Wilkins. 2007. p. 1701.
  • 10 Khosla D, Patel FD, Shukla AK, Rai B, Oinam AS, Sharma SC, et al. Dosimetric evaluation and clinical outcome in post-operative patients of carcinoma vulva treated with intensity-modulated radiotherapy. Indian J Cancer 2015;52:670-5.
  • 11 Beriwal S, Coon D, Heron DE, Kelley JL, Edwards RP, Sukumvanich P, et al. Preoperative intensity-modulated radiotherapy and chemotherapy for locally advanced vulvar carcinoma. Gynecol Oncol 2008;109:291-5.
  • 12 Bloemers MC, Portelance L, Ruo R, Parker W, Souhami L. A dosimetric evaluation of dose escalation for the radical treatment of locally advanced vulvar cancer by intensity-modulated radiation therapy. Med Dosim 2012;37:310-3.