Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva
Identifieur interne : 003114 ( Pmc/Curation ); précédent : 003113; suivant : 003115Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva
Auteurs : A. Gaudineau ; D. Weitbruch ; P. Quetin [France] ; S. Heymann [France] ; T. Petit ; P. Volkmar ; F. Bodin ; M. Velten [France] ; J. F. RodierSource :
- Oncology Letters [ 1792-1074 ] ; 2012.
Abstract
Alternative therapies have been sought to alleviate mutilation and morbidity associated with surgery for vulvar neoplasms. Our prime objective was to assess tumor absence in pathological vulvar and nodal specimens following neoadjuvant chemoradiotherapy in locally advanced vulvar neoplasms. Data were retrospectively collected from January 2001 to May 2009 from 22 patients treated with neoadjuvant therapy for locally advanced squamous cell carcinoma of the vulva. Neoadjuvant treatment consisted of inguino-pelvic radiotherapy (50 Gy) in association with chemotherapy when possible. Surgery occurred at intervals of between 5 to 8 weeks. The median age of patients at diagnosis was 74.1 years. All patients were primarily treated with radiotherapy and 15 received a concomitant chemotherapy. Additionally, all patients underwent radical vulvectomy and bilateral inguino-femoral lymphadenectomy. Tumor absence in the vulvar and nodal pathological specimens was achieved for 6 (27%) patients, while absence in the vulvar pathological specimens was only achieved for 10 (45.4%) patients. Postoperative follow-up revealed breakdown of groin wounds, vulvar wounds and chronic lymphedema in 3 (14.3%), 7 (31.8%) and 14 cases (63.6%), respectively. Within a median follow-up time of 2.3 years [interquartile range (IQR), 0.6–4.6], 12 (54.6%) patients experienced complete remission and 6 cases succumbed to metastatic evolution within a median of 2.2 years (IQR, 0.6–4.6), with 1 case also experiencing perineal recurrence. Median survival time, estimated using the Kaplan-Meier method, was 5.1 years (IQR, 1.0–6.8). We suggest that neoadjuvant chemoradiotherapy may represent a reliable and promising strategy in locally advanced squamous cell carcinoma of the vulva.
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DOI: 10.3892/ol.2012.831
PubMed: 23205089
PubMed Central: 3506666
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P. Quetin<affiliation><nlm:aff id="af3-ol-04-04-0719">Department of Radiotherapy, Bon-Secours Hospital, 57000 Metz;</nlm:aff>
<wicri:noCountry code="subfield">57000 Metz</wicri:noCountry>
</affiliation>
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<front><div type="abstract" xml:lang="en"><p>Alternative therapies have been sought to alleviate mutilation and morbidity associated with surgery for vulvar neoplasms. Our prime objective was to assess tumor absence in pathological vulvar and nodal specimens following neoadjuvant chemoradiotherapy in locally advanced vulvar neoplasms. Data were retrospectively collected from January 2001 to May 2009 from 22 patients treated with neoadjuvant therapy for locally advanced squamous cell carcinoma of the vulva. Neoadjuvant treatment consisted of inguino-pelvic radiotherapy (50 Gy) in association with chemotherapy when possible. Surgery occurred at intervals of between 5 to 8 weeks. The median age of patients at diagnosis was 74.1 years. All patients were primarily treated with radiotherapy and 15 received a concomitant chemotherapy. Additionally, all patients underwent radical vulvectomy and bilateral inguino-femoral lymphadenectomy. Tumor absence in the vulvar and nodal pathological specimens was achieved for 6 (27%) patients, while absence in the vulvar pathological specimens was only achieved for 10 (45.4%) patients. Postoperative follow-up revealed breakdown of groin wounds, vulvar wounds and chronic lymphedema in 3 (14.3%), 7 (31.8%) and 14 cases (63.6%), respectively. Within a median follow-up time of 2.3 years [interquartile range (IQR), 0.6–4.6], 12 (54.6%) patients experienced complete remission and 6 cases succumbed to metastatic evolution within a median of 2.2 years (IQR, 0.6–4.6), with 1 case also experiencing perineal recurrence. Median survival time, estimated using the Kaplan-Meier method, was 5.1 years (IQR, 1.0–6.8). We suggest that neoadjuvant chemoradiotherapy may represent a reliable and promising strategy in locally advanced squamous cell carcinoma of the vulva.</p>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Oncol Lett</journal-id>
<journal-id journal-id-type="iso-abbrev">Oncol Lett</journal-id>
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<article-categories><subj-group subj-group-type="heading"><subject>Articles</subject>
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<title-group><article-title>Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>GAUDINEAU</surname>
<given-names>A.</given-names>
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Departments of Surgical Oncology and</aff>
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Radiotherapy, Regional Paul Strauss Cancer Centre, 67065 Strasbourg;</aff>
<aff id="af3-ol-04-04-0719"><label>3</label>
Department of Radiotherapy, Bon-Secours Hospital, 57000 Metz;</aff>
<aff id="af4-ol-04-04-0719"><label>4</label>
Departments of Medical Oncology and</aff>
<aff id="af5-ol-04-04-0719"><label>5</label>
Biostatistics, Regional Paul Strauss Cancer Centre, 67065 Strasbourg,<country>France</country>
</aff>
<author-notes><corresp id="c1-ol-04-04-0719">Correspondence to: Professor Jean-François Rodier, Department of Surgical Oncology, Regional Paul Strauss Cancer Centre, 3 rue de la Porte de l’Hôpital, BP 42, 67065 Strasbourg, France, E-mail: <email>jrodier@strasbourg.unicancer.fr</email>
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</author-notes>
<pub-date pub-type="ppub"><month>10</month>
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</pub-date>
<pub-date pub-type="epub"><day>27</day>
<month>7</month>
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<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
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<volume>4</volume>
<issue>4</issue>
<fpage>719</fpage>
<lpage>722</lpage>
<history><date date-type="received"><day>06</day>
<month>3</month>
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</date>
<date date-type="accepted"><day>13</day>
<month>6</month>
<year>2012</year>
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<permissions><copyright-statement>Copyright © 2012, Spandidos Publications</copyright-statement>
<copyright-year>2012</copyright-year>
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<abstract><p>Alternative therapies have been sought to alleviate mutilation and morbidity associated with surgery for vulvar neoplasms. Our prime objective was to assess tumor absence in pathological vulvar and nodal specimens following neoadjuvant chemoradiotherapy in locally advanced vulvar neoplasms. Data were retrospectively collected from January 2001 to May 2009 from 22 patients treated with neoadjuvant therapy for locally advanced squamous cell carcinoma of the vulva. Neoadjuvant treatment consisted of inguino-pelvic radiotherapy (50 Gy) in association with chemotherapy when possible. Surgery occurred at intervals of between 5 to 8 weeks. The median age of patients at diagnosis was 74.1 years. All patients were primarily treated with radiotherapy and 15 received a concomitant chemotherapy. Additionally, all patients underwent radical vulvectomy and bilateral inguino-femoral lymphadenectomy. Tumor absence in the vulvar and nodal pathological specimens was achieved for 6 (27%) patients, while absence in the vulvar pathological specimens was only achieved for 10 (45.4%) patients. Postoperative follow-up revealed breakdown of groin wounds, vulvar wounds and chronic lymphedema in 3 (14.3%), 7 (31.8%) and 14 cases (63.6%), respectively. Within a median follow-up time of 2.3 years [interquartile range (IQR), 0.6–4.6], 12 (54.6%) patients experienced complete remission and 6 cases succumbed to metastatic evolution within a median of 2.2 years (IQR, 0.6–4.6), with 1 case also experiencing perineal recurrence. Median survival time, estimated using the Kaplan-Meier method, was 5.1 years (IQR, 1.0–6.8). We suggest that neoadjuvant chemoradiotherapy may represent a reliable and promising strategy in locally advanced squamous cell carcinoma of the vulva.</p>
</abstract>
<kwd-group><kwd>vulvar neoplasms</kwd>
<kwd>squamous sell carcinoma</kwd>
<kwd>neoadjuvant chemoradiotherapy</kwd>
<kwd>surgery</kwd>
</kwd-group>
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