Role of radiation therapy in the treatment of advanced vulvar carcinoma

To evaluate different methods of radiation therapy for advanced vulvar malignancy, a retrospective study was done on 33 patients treated with radiation between 1950 and 1979. Group I consisted of 18 patients treated with surgery and radiation and group II of 15 patients treated with radiation alone. The patients received several kinds of radiation therapy. Group I received radiotherapy because of local recurrence or positive lymph nodes found in the groin and/or pelvis; the overall survival in that group ranged from 3 months to 11 years. Group II received radiation only because of locally advanced disease and/or associated medical problems; the overall survival in that group ranged from 2 to 40 months. We concluded that megavoltage radiation minimized the local reaction and that better local control was obtained with a combination of photons and electrons and an interstitial implant. Postoperative radiation for positive lymph nodes prevented local recurrence but did not seem to improve survival.