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Outcomes after radiation therapy with concurrent weekly platinum-based chemotherapy or every-3-4-week 5-fluorouracil-containing regimens for squamous cell carcinoma of the vulva.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2011 Jan; Vol. 120 (1), pp. 101-7. Date of Electronic Publication: 2010 Oct 14. - Publication Year :
- 2011
-
Abstract
- Objective: To compare outcomes in patients with squamous cell carcinoma (SCC) of the vulva treated with radiation (RT) and concurrent weekly platinum-based or every-3-4-week regimens containing 5-fluorouracil (5-FU).<br />Methods: Records of 44 patients with vulvar SCC treated with concurrent chemotherapy and radiation (chemoRT) from 1988 to 2008 were reviewed. Rates of disease-free survival (DFS), overall survival (OS), locoregional recurrence (LRR), and distant metastases (DM) were estimated using the Kaplan-Meier method.<br />Results: The median age was 63 years (range, 44-90), 84.1% of patients had ECOG performance status 0-1, and patients had FIGO Stage II (n=6), III (n=31), or IVA (n=7) disease. Patients were treated preoperatively (n=10), postoperatively (n=10), or without surgery (n=24). The median RT dose to the vulva was 50.2 Gray (range, 22-75). Concurrent chemotherapy regimens included weekly platinum (n=16) or every 3-4 week regimens with 5-FU as the backbone (n=28). With a median follow-up of 31.5 months, there was no significant difference in 2-year OS (74.5% vs. 70.0%; p=0.65), DFS (61.9% vs. 56.0%; p=0.85), LRR (31.3% vs. 32.9%; p=0.93), or DM (6.3% vs. 10.6%; p=0.81) between the weekly platinum and every-3-4-week 5-FU regimens. Twenty patients (45.4%) recurred: 16 LRR, 2 DM, and 2 with both. The clinical and pathologic complete response rates were 58.8% (20/34), and 53.8% (14/26), respectively. There was a higher proportion of grade 3 or higher acute non-skin toxicities in patients receiving every-3-4-week 5-FU (46.1% vs. 13.3%; p=0.07), but more grade 3 or higher skin toxicity in patients receiving weekly platinum (62.5% vs. 32.0%; p=0.01).<br />Conclusion: OS, response rates, and recurrence rates were not significantly different after RT with concurrent weekly platinum-based versus every-3-4-week regimens containing 5-FU for vulvar SCC.<br /> (Copyright © 2010 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols adverse effects
Carcinoma, Squamous Cell surgery
Cisplatin administration & dosage
Cisplatin adverse effects
Combined Modality Therapy
Disease-Free Survival
Drug Administration Schedule
Female
Fluorouracil administration & dosage
Fluorouracil adverse effects
Humans
Middle Aged
Organoplatinum Compounds administration & dosage
Organoplatinum Compounds adverse effects
Retrospective Studies
Treatment Outcome
Vulvar Neoplasms surgery
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Carcinoma, Squamous Cell drug therapy
Carcinoma, Squamous Cell radiotherapy
Vulvar Neoplasms drug therapy
Vulvar Neoplasms radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 120
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 20950845
- Full Text :
- https://doi.org/10.1016/j.ygyno.2010.09.004