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Postoperative radiation therapy for extramammary Paget's disease
- Source :
- British Journal of Dermatology. 172:1014-1020
- Publication Year :
- 2015
- Publisher :
- Oxford University Press (OUP), 2015.
-
Abstract
- SummaryBackground Extramammary Paget's disease (EMPD) is a rare cutaneous malignancy that is usually treated with surgery. Patients with positive surgical margins require adjuvant therapy, but there have been few reports on the use of radiation therapy. Objectives To investigate the effectiveness of postoperative radiation therapy in EMPD. Materials and methods Twenty-one patients with EMPD involving the genitalia underwent radiation therapy as adjuvant therapy after surgery. Ten patients had inguinal lymph node involvement before radiation therapy, but none had distant metastases. A median total dose of 59·4 Gy (range, 45–64·8 Gy) was delivered to the tumour bed in 30 fractions (range, 23–36 fractions). Results At a median follow-up period of 38 months, all patients had local control. However, six patients had developed distant metastases 6–43 months after radiation therapy. The distant metastasis-free rates were 66% at 3 years and 55% at 5 years. Inguinal lymph node involvement was a significant risk factor for distant metastases. Four patients died 33–58 months after irradiation; the causes of death were tumour progression in three patients and infectious pneumonia in one. The overall and cause-specific survival rates were both 92% at 3 years, and 62% and 71% at 5 years, respectively. No therapy-related toxicities of grade ≥ 3 were observed. Conclusions Postoperative radiation therapy is safe and effective in maintaining local control in patients with EMPD.
- Subjects :
- Male
medicine.medical_specialty
Genital Neoplasms, Female
medicine.medical_treatment
Dermatology
Disease
Perineum
Extramammary Paget's disease
medicine
Adjuvant therapy
Humans
Aged
Aged, 80 and over
Postoperative Care
business.industry
Postoperative radiation
Middle Aged
medicine.disease
Surgery
Radiation therapy
Pneumonia
Paget Disease, Extramammary
Treatment Outcome
Total dose
Genital Neoplasms, Male
Female
Radiotherapy, Adjuvant
Positive Surgical Margin
business
Subjects
Details
- ISSN :
- 00070963
- Volume :
- 172
- Database :
- OpenAIRE
- Journal :
- British Journal of Dermatology
- Accession number :
- edsair.doi.dedup.....4ba2f0ae48990970ac0a303cf1040852