Concurrent chemoradiation for locally advanced squamous vulva carcinoma

Abstract

5169 Background: The purpose of this study is to evaluate a regimen of chemoradiotherapy for those patients with locally advanced squamous cell carcinoma of the vulva. Methods: From July 2000 to February 2004, eleven patients with the diagnosis of locally advanced squamous cell carcinoma of the vulva were treated with simultaneous chemoradiation The median age was 48 years old (32 to 66). Ninety-one percent (10 out of 11) of the histopathology revealed well-differentiated cell-type. Nine patients (81.9%) were stage IV disease and the other 2 patients (18.2%) were stage III. The radiotherapy is the locoregional treatment including the vulva, pelvic and bilateral groin regions. The pelvic radiation prescribed dose ranged from 45 to 60 Gy and the vulva and groin regions ranged from 45 to 70 Gy, given with the conventional fractionation (180 to 200 cGy per daily fraction, 5 times a week). The chemotherapy regimen was the combination of mitomycin 12 mg/m2 on day 1 plus 5-fluorouracil 1,000 mg/m2/day on days 1 through 4, every 28 days for 2 cycles. Results: The overall responsiveness was 100% with 7 (63.7%) complete response and 4 (36.4%) partial response. At the median follow up of 12 months (6 to 24 months), there was only one patient (9.1%) developed local recurrent disease at 5 months. There were 3 patients (27.3%) experienced grade III skin reaction and 2 patients (18.2%) had grade III anemia and 2 patients (27.3%) had grade III granulocytopenia. No patients died from the treatment. Conclusions: Concurrent chemoradiation is highly effective and well tolerated for this disease and may hold curative potential for some patients with surgically unresectable or medical inoperable situations. No significant financial relationships to disclose.