Combined preoperative chemoradiotherapy followed by radical surgery in locally advanced vulvar carcinoma: A pilot study

Giovanni Lupi, Francesco Raspagliesi, Roberto Zucali, Rosanna Fontanelli, Dario Paladini, Rado Kenda, Francesco Di Re

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND. Although for decades exenterative surgery has represented the standard treatment for patients with locally advanced vulvar cancer, combined approaches, including preoperative radiation with or without chemotherapy, are now considered tile treatment of choice. We report the results of a pilot study on concurrent chemoradiotherapy followed by radical surgery for patients with locally advanced squamous cell carcinoma of the vulva. METHODS. Thirty-one patient with squamous cell carcinoma of the vulva were treated with two courses of combination chemotherapy mitomycin C, 15 mg/m2 intravenously (i.v.) on Day 1, and 5-fluororacil, 750 ms/m2 i.v., in continuous 24-hour infusion on Days 1 to 5. Inguinal and pelvic lymph node chains and the vulva were irradiated (starting on the same day as the chemotherapy) up to a total dose of 36 Gy. After a 2-week interval, a second course of chemoradiotherapy was given (18 Gy on the vulvar region only). After 2 weeks, patients underwent radical surgery. RESULTS. An objective response was observed in 22 of 24 primary cases (91.6%) and in 7 of 7 recurrent cases. All but two unresponsive patients underwent radical surgery. The postoperative morbidity rate was 65% (19 of 29 patients), and the mortality rate was 13.8% (4 of 29 patients). Five of nine patients (55%) with biopsy-proven inguinal lymph node metastases showed no residual lymph node disease in the surgical specimen. The recurrence rate was 31.8% and the median follow-up time was 34 months. CONCLUSIONS. Chemoradiotherapy seems to be effective for squamous cell carcinoma of the vulva. If treatment related morbidity could be decreased, such a combined approach might offer new perspectives for a conservative treatment of locally advanced vulvar cancer.

Original languageEnglish
Pages (from-to)1472-1478
Number of pages7
JournalCancer
Volume77
Issue number8
DOIs
Publication statusPublished - Apr 15 1996

Keywords

  • chemotherapy
  • radiotherapy
  • squamous cell carcinoma
  • surgery
  • valve

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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