Role of primary chemoradiotherapy in the management of advanced stage vulvar cancer : Experience of a large cancer center.

IF 2.5 3区医学 Q3 ONCOLOGY

Strahlentherapie und Onkologie Pub Date : 2026-05-01 Epub Date: 2025-11-10 DOI:10.1007/s00066-025-02483-z

Lars Wessel, Maria Vinsensia, Thomas Koenigsmann, Juergen Debus, Nathalie Arians

{"title":"Role of primary chemoradiotherapy in the management of advanced stage vulvar cancer : Experience of a large cancer center.","authors":"Lars Wessel, Maria Vinsensia, Thomas Koenigsmann, Juergen Debus, Nathalie Arians","doi":"10.1007/s00066-025-02483-z","DOIUrl":null,"url":null,"abstract":"Purpose: Treatment of advanced vulvar cancer is challenging. The aim of the study was to investigate the potential of primary (chemo)radiotherapy ((C)RT) with regard to clinical outcome and associated prognostic parameters.Methods: A total of 39 patients with squamous cell vulvar cancer receiving primary (C)RT were retrospectively identified through hospital databases. Patient and treatment characteristics as well as outcomes were assessed. Survival statistics were calculated using the Kaplan-Meier method. Univariate analysis was performed using the log-rank test and Spearman's correlation to evaluate associations between patient or treatment characteristics and survival outcomes.Results: Median age at diagnosis was 74 years (range 38-92 years). Patients had advanced stage disease with 28.2%/38.5% presenting with FIGO stage III/IV, respectively. All patients received external beam radiotherapy (EBRT) with a median dose to the primary tumor of 66 Gy EQD2 (range 49.6 Gy-72.6 Gy) and to lymph nodes of 53.1 Gy EQD2 (range 44.1 Gy-67.1 Gy). 69.2% received concurrent chemotherapy, mostly cisplatin weekly or mitomycin/5-fluorouracil. 10.3%/64.1% showed clinical complete remission (cCR)/partial remission (cPR) at first follow-up; 7.7% had disease progression. After a median follow-up of 25.5 months (range 0.5-132.9 months), 3‑year locoregional progression-free survival (LRPFS) and overall survival (OS) were 60.2% and 69.6%, respectively. Age and concurrent chemotherapy were the main prognostic parameters associated with improved oncological outcome.Conclusion: Definitive (C)RT plays an important role in the management of advanced vulvar cancer with high response rates and satisfactory oncological outcomes. However, there is still room for improvement and future trials are needed to further assess the potential of definitive CRT, especially with regard to possible combinations with immunotherapy.","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"516-525"},"PeriodicalIF":2.5000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109232/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Strahlentherapie und Onkologie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00066-025-02483-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/11/10 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Treatment of advanced vulvar cancer is challenging. The aim of the study was to investigate the potential of primary (chemo)radiotherapy ((C)RT) with regard to clinical outcome and associated prognostic parameters.

Methods: A total of 39 patients with squamous cell vulvar cancer receiving primary (C)RT were retrospectively identified through hospital databases. Patient and treatment characteristics as well as outcomes were assessed. Survival statistics were calculated using the Kaplan-Meier method. Univariate analysis was performed using the log-rank test and Spearman's correlation to evaluate associations between patient or treatment characteristics and survival outcomes.

Results: Median age at diagnosis was 74 years (range 38-92 years). Patients had advanced stage disease with 28.2%/38.5% presenting with FIGO stage III/IV, respectively. All patients received external beam radiotherapy (EBRT) with a median dose to the primary tumor of 66 Gy EQD2 (range 49.6 Gy-72.6 Gy) and to lymph nodes of 53.1 Gy EQD2 (range 44.1 Gy-67.1 Gy). 69.2% received concurrent chemotherapy, mostly cisplatin weekly or mitomycin/5-fluorouracil. 10.3%/64.1% showed clinical complete remission (cCR)/partial remission (cPR) at first follow-up; 7.7% had disease progression. After a median follow-up of 25.5 months (range 0.5-132.9 months), 3‑year locoregional progression-free survival (LRPFS) and overall survival (OS) were 60.2% and 69.6%, respectively. Age and concurrent chemotherapy were the main prognostic parameters associated with improved oncological outcome.

Conclusion: Definitive (C)RT plays an important role in the management of advanced vulvar cancer with high response rates and satisfactory oncological outcomes. However, there is still room for improvement and future trials are needed to further assess the potential of definitive CRT, especially with regard to possible combinations with immunotherapy.

查看原文本刊更多论文

一期放化疗在晚期外阴癌治疗中的作用：一家大型癌症中心的经验。

目的：晚期外阴癌的治疗具有挑战性。该研究的目的是调查原发性（化疗）放疗（(C)RT）在临床结果和相关预后参数方面的潜力。方法：回顾性分析39例接受原发性(C)外阴鳞状细胞癌患者的临床资料。评估患者和治疗特征以及结果。生存统计采用Kaplan-Meier法计算。采用log-rank检验和Spearman相关进行单因素分析，以评估患者或治疗特征与生存结果之间的关系。结果：诊断时中位年龄为74岁（范围38-92岁）。患者为晚期疾病，分别有28.2%/38.5%出现FIGO III/IV期。所有患者均接受外束放疗（EBRT），原发肿瘤的中位剂量为66 Gy EQD2（范围49.6 Gy-72.6 Gy），淋巴结的中位剂量为53.1 Gy EQD2（范围44.1 Gy-67.1 Gy）。69.2%的患者同时接受化疗，以每周顺铂或丝裂霉素/5-氟尿嘧啶为主。首次随访时临床完全缓解(cCR)/部分缓解（cPR）为10.3%/64.1%；7.7%有疾病进展。中位随访25.5个月（0.5-132.9个月）后，3年局部无进展生存期（LRPFS）和总生存期（OS）分别为60.2%和69.6%。年龄和同期化疗是与肿瘤预后改善相关的主要预后参数。结论：终末期(C)放射治疗在晚期外阴癌的治疗中具有重要作用，治疗有效率高，肿瘤预后满意。然而，仍有改进的空间，未来的试验需要进一步评估明确的CRT的潜力，特别是关于可能与免疫治疗的联合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Strahlentherapie und Onkologie 医学-核医学

CiteScore

5.70

自引率

12.90%

发文量

141

审稿时长

3-8 weeks

期刊介绍： Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research. Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.