TY - JOUR
T1 - 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
AU - Mak, Raymond H.
AU - Halasz, Lia M.
AU - Tanaka, Cynthia K.
AU - Ancukiewicz, Marek
AU - Schultz, Delray J.
AU - Russell, Anthony H.
AU - Viswanathan, Akila N.
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2011/1
Y1 - 2011/1
N2 - 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). 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. 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). 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.
AB - 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). 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. 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). 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.
KW - Chemotherapy
KW - Radiotherapy
KW - Squamous cell carcinoma
KW - Vulvar cancer
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U2 - 10.1016/j.ygyno.2010.09.004
DO - 10.1016/j.ygyno.2010.09.004
M3 - Article
C2 - 20950845
AN - SCOPUS:78649908683
SN - 0090-8258
VL - 120
SP - 101
EP - 107
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1
ER -