Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy
Identifieur interne : 002626 ( Pmc/Checkpoint ); précédent : 002625; suivant : 002627Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy
Auteurs : Jayoung Lee [Corée du Sud] ; Sung Hwan Kim [Corée du Sud] ; Giwon Kim [Corée du Sud] ; Mina Yu [Corée du Sud] ; Dong-Choon Park [Corée du Sud] ; Joo-Hee Yoon [Corée du Sud] ; Sei-Chul Yoon [Corée du Sud]Source :
- Radiation Oncology Journal [ 2234-1900 ] ; 2012.
Abstract
To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy.
The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy.
Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications.
Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.
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DOI: 10.3857/roj.2012.30.1.20
PubMed: 23120740
PubMed Central: 3475959
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The Catholic University of Korea School of Medicine, Suwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon</wicri:regionArea><wicri:noRegion>Suwon</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Giwon" sort="Kim, Giwon" uniqKey="Kim G" first="Giwon" last="Kim">Giwon Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon</wicri:regionArea><wicri:noRegion>Suwon</wicri:noRegion></affiliation></author><author><name sortKey="Yu, Mina" sort="Yu, Mina" uniqKey="Yu M" first="Mina" last="Yu">Mina Yu</name><affiliation wicri:level="3"><nlm:aff id="A2">Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Park, Dong Choon" sort="Park, Dong Choon" uniqKey="Park D" first="Dong-Choon" last="Park">Dong-Choon Park</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon</wicri:regionArea><wicri:noRegion>Suwon</wicri:noRegion></affiliation></author><author><name sortKey="Yoon, Joo Hee" sort="Yoon, Joo Hee" uniqKey="Yoon J" first="Joo-Hee" last="Yoon">Joo-Hee Yoon</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon</wicri:regionArea><wicri:noRegion>Suwon</wicri:noRegion></affiliation></author><author><name sortKey="Yoon, Sei Chul" sort="Yoon, Sei Chul" uniqKey="Yoon S" first="Sei-Chul" last="Yoon">Sei-Chul Yoon</name><affiliation wicri:level="3"><nlm:aff id="A2">Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23120740</idno><idno type="pmc">3475959</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475959</idno><idno type="RBID">PMC:3475959</idno><idno type="doi">10.3857/roj.2012.30.1.20</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">004606</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004606</idno><idno type="wicri:Area/Pmc/Curation">004605</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004605</idno><idno type="wicri:Area/Pmc/Checkpoint">002626</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002626</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy</title><author><name sortKey="Lee, Jayoung" sort="Lee, Jayoung" uniqKey="Lee J" first="Jayoung" last="Lee">Jayoung Lee</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon</wicri:regionArea><wicri:noRegion>Suwon</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Sung Hwan" sort="Kim, Sung Hwan" uniqKey="Kim S" first="Sung Hwan" last="Kim">Sung Hwan Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon</wicri:regionArea><wicri:noRegion>Suwon</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Giwon" sort="Kim, Giwon" uniqKey="Kim G" first="Giwon" last="Kim">Giwon Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon</wicri:regionArea><wicri:noRegion>Suwon</wicri:noRegion></affiliation></author><author><name sortKey="Yu, Mina" sort="Yu, Mina" uniqKey="Yu M" first="Mina" last="Yu">Mina Yu</name><affiliation wicri:level="3"><nlm:aff id="A2">Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Park, Dong Choon" sort="Park, Dong Choon" uniqKey="Park D" first="Dong-Choon" last="Park">Dong-Choon Park</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon</wicri:regionArea><wicri:noRegion>Suwon</wicri:noRegion></affiliation></author><author><name sortKey="Yoon, Joo Hee" sort="Yoon, Joo Hee" uniqKey="Yoon J" first="Joo-Hee" last="Yoon">Joo-Hee Yoon</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon</wicri:regionArea><wicri:noRegion>Suwon</wicri:noRegion></affiliation></author><author><name sortKey="Yoon, Sei Chul" sort="Yoon, Sei Chul" uniqKey="Yoon S" first="Sei-Chul" last="Yoon">Sei-Chul Yoon</name><affiliation wicri:level="3"><nlm:aff id="A2">Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author></analytic><series><title level="j">Radiation Oncology Journal</title><idno type="ISSN">2234-1900</idno><idno type="eISSN">2234-3164</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy.</p></sec><sec><title>Materials and Methods</title><p>The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy.</p></sec><sec><title>Results</title><p>Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications.</p></sec><sec><title>Conclusion</title><p>Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Jung, Kw" uniqKey="Jung K">KW Jung</name></author><author><name sortKey="Park, S" uniqKey="Park S">S Park</name></author><author><name sortKey="Kong, Hj" uniqKey="Kong H">HJ Kong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lin, Jy" uniqKey="Lin J">JY Lin</name></author><author><name sortKey="Dubeshter, B" uniqKey="Dubeshter B">B DuBeshter</name></author><author><name sortKey="Angel, C" uniqKey="Angel C">C Angel</name></author><author><name sortKey="Dvoretsky, Pm" uniqKey="Dvoretsky P">PM Dvoretsky</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gould, N" uniqKey="Gould N">N Gould</name></author><author><name sortKey="Kamelle, S" uniqKey="Kamelle S">S Kamelle</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Radiation Oncol J</journal-id><journal-id journal-id-type="iso-abbrev">Radiation Oncol J</journal-id><journal-id journal-id-type="publisher-id">ROJ</journal-id><journal-title-group><journal-title>Radiation Oncology Journal</journal-title></journal-title-group><issn pub-type="ppub">2234-1900</issn><issn pub-type="epub">2234-3164</issn><publisher><publisher-name>The Korean Society for Radiation Oncology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23120740</article-id><article-id pub-id-type="pmc">3475959</article-id><article-id pub-id-type="doi">10.3857/roj.2012.30.1.20</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject><subj-group><subject>Clinical Investigation</subject></subj-group></subj-group></article-categories><title-group><article-title>Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Jayoung</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Kim</surname><given-names>Sung Hwan</given-names></name><degrees>MD</degrees><degrees>PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Giwon</given-names></name><degrees>MD</degrees><degrees>PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Yu</surname><given-names>Mina</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Park</surname><given-names>Dong-Choon</given-names></name><degrees>MD</degrees><degrees>PhD</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Yoon</surname><given-names>Joo-Hee</given-names></name><degrees>MD</degrees><degrees>PhD</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Yoon</surname><given-names>Sei-Chul</given-names></name><degrees>MD</degrees><degrees>PhD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</aff><aff id="A2"><label>2</label>Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.</aff><aff id="A3"><label>3</label>Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.</aff><author-notes><corresp>Correspondence: Sung Hwan Kim, MD, PhD, Department of Radiation Oncology, St. Vincent's Hospital, 93 Jungbu-daero, Paldal-gu, Suwon 442-723, Korea. Tel: +82-31-249-7565, Fax: +82-31-242-3734, <email>kimandre@catholic.ac.kr</email></corresp></author-notes><pub-date pub-type="ppub"><month>3</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>31</day><month>3</month><year>2012</year></pub-date><volume>30</volume><issue>1</issue><fpage>20</fpage><lpage>26</lpage><history><date date-type="received"><day>29</day><month>2</month><year>2012</year></date><date date-type="rev-recd"><day>12</day><month>3</month><year>2012</year></date><date date-type="accepted"><day>21</day><month>3</month><year>2012</year></date></history><permissions><copyright-statement>Copyright © 2012. The Korean Society for Radiation Oncology</copyright-statement><copyright-year>2012</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Purpose</title><p>To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy.</p></sec><sec><title>Materials and Methods</title><p>The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy.</p></sec><sec><title>Results</title><p>Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications.</p></sec><sec><title>Conclusion</title><p>Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.</p></sec></abstract><kwd-group><kwd>Vulvar neoplasms</kwd><kwd>Squamous cell carcinoma</kwd><kwd>Paget's disease</kwd><kwd>Postoperative radiotherapy</kwd><kwd>Concurrent chemoradiotherapy</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" position="float"><label>Fig. 1</label><caption><p>Kaplan-Meier survival analysis; overall survival (A) and disease free survival (B) of patients with vulvar cancer treated with radiotherapy (n = 20).</p></caption><graphic xlink:href="roj-30-20-g001"></graphic></fig><fig id="F2" position="float"><label>Fig. 2</label><caption><p>Overall survival of patients with vulvar cancer according to treatment response. PR, partial reponse; SD, stable disease; PD, progressed disease.</p></caption><graphic xlink:href="roj-30-20-g002"></graphic></fig><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Patient characteristics</p></caption><graphic xlink:href="roj-30-20-i001"></graphic><table-wrap-foot><fn><p>AJCC, American Joint Committee on Cancer; KPS, Karnofsky performance status scale.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T2" position="float"><label>Table 2</label><caption><p>Treatment characteristics</p></caption><graphic xlink:href="roj-30-20-i002"></graphic><table-wrap-foot><fn><p>CCRT, concurrent chemoradiotherapy; RT, radiotherapy; LND, lymph node dissection; 5-FU, 5-fluorouracil.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T3" position="float"><label>Table 3</label><caption><p>Treatment outcome and patterns of failure</p></caption><graphic xlink:href="roj-30-20-i003"></graphic><table-wrap-foot><fn><p>PR, partial response.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T4" position="float"><label>Table 4</label><caption><p>Treatment related acute complications</p></caption><graphic xlink:href="roj-30-20-i004"></graphic><table-wrap-foot><fn><p>RTOG, Radiation Therapy Oncology Group.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T5" position="float"><label>Table 5</label><caption><p>Severe late complications according to the treatment modality</p></caption><graphic xlink:href="roj-30-20-i005"></graphic></table-wrap></floats-group></pmc><affiliations><list><country><li>Corée du Sud</li></country><region><li>Région capitale de Séoul</li></region><settlement><li>Séoul</li></settlement></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Lee, Jayoung" sort="Lee, Jayoung" uniqKey="Lee J" first="Jayoung" last="Lee">Jayoung Lee</name></noRegion><name sortKey="Kim, Giwon" sort="Kim, Giwon" uniqKey="Kim G" first="Giwon" last="Kim">Giwon Kim</name><name sortKey="Kim, Sung Hwan" sort="Kim, Sung Hwan" uniqKey="Kim S" first="Sung Hwan" last="Kim">Sung Hwan Kim</name><name sortKey="Park, Dong Choon" sort="Park, Dong Choon" uniqKey="Park D" first="Dong-Choon" last="Park">Dong-Choon Park</name><name sortKey="Yoon, Joo Hee" sort="Yoon, Joo Hee" uniqKey="Yoon J" first="Joo-Hee" last="Yoon">Joo-Hee Yoon</name><name sortKey="Yoon, Sei Chul" sort="Yoon, Sei Chul" uniqKey="Yoon S" first="Sei-Chul" last="Yoon">Sei-Chul Yoon</name><name sortKey="Yu, Mina" sort="Yu, Mina" uniqKey="Yu M" first="Mina" last="Yu">Mina Yu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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