Outcome of Definitive Treatments in Primary Vaginal Cancer Patients: An Institutional Review

Abstract

To review the treatment outcome in primary vaginal cancer patients who underwent definitive treatment at our institution. A total of 43 patients with histologically proven primary vaginal cancer, who were treated between January 2005 to December 2015, were identified. All were treated with definitive radiotherapy with or without concurrent chemotherapy. Radiotherapy was delivered as a combination of external beam radiotherapy and brachytherapy to a minimum dose of 60 Gy. Four patients were FIGO stage I, 13 were stage II, 23 stage III patients and three patients were stage IVA. The median age was 60 years (range 42–76). The median follow-up was 29 months with a range of 3 to 70 months. The different variables looked into like the histology, lower third of vagina involvement and prior hysterectomy did not show any difference in survival. Addition of concurrent chemotherapy was the only factor which showed a trend towards better survival with a p value of 0.09. Even in the subset of patients with prior hysterectomy, those who received definitive treatment with concurrent chemo-radiotherapy had a better two-year progression-free survival than those who received radiotherapy alone (57.4% Vs 10.5%). A combination of EBRT and brachytherapy with concurrent chemotherapy is a reasonable option in the management of primary vaginal cancer. Further optimization of the dose and techniques of radiotherapy are warranted.