Definitive Radiotherapy for Treatment of Primary Vaginal Cancer: Effectiveness and Prognostic Factors. Issue 3 (1st March 2012)

• Record Type: Journal Article
• Authors: Jang, Won Il; Wu, Hong-Gyun; Ha, Sung Whan; Kim, Hak Jae; Kang, Soon Beom; Song, Yong Sang; Park, Noh-Hyun; Kim, Jae Weon
• Is Part Of: International journal of gynecological cancer. Volume 22:Issue 3(2012)
• Page Start: 521
• Page End: 527
• Publication Date: 2012-03-01
• Subjects: Vaginal cancer -- Radiotherapy -- Effectiveness -- Prognostic factors; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0b013e31823fd621
• Languages: English
• ISSNs: 1048-891X

Abstract

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.