Radiation Therapy for Extramammary Paget Disease: Treatment Outcomes and Prognostic Factors

Extensive Extramammary Paget’s Disease With Underlying Perianal Adenocarcinoma: The Role of Neoadjuvant Radiation Treatment

“…Besa et al [13] have reported the same success for such patients, except for local recurrence in one of two of their patients with underlying carcinoma postdefinitive radiation therapy. Doses that have been reported in the literature are mainly 60 Gy to the gross tumour volume, with a 2 cm margin [14]. Of note, there have been no randomised controlled trials directly comparing surgical excision with definitive radiotherapy for the treatment of EMPD.…”

“…Poor prognostic markers include lymph node metastasis, dermal invasion, tumour thickness, advanced stage, positive surgical margins, lymphovascular involvement, and high Ki-67 expression [4]. Lymph node metastasis and dermal invasion have been reported to have significant impacts on distant metastasis-free rates and overall survival [14]. At three years, distant metastasis-free rates are 33% and 89% in patients with and without regional lymph node metastasis respectively, and for dermal invasion, 51% and 92% for with and without respectively [14].…”

“…Lymph node metastasis and dermal invasion have been reported to have significant impacts on distant metastasis-free rates and overall survival [14]. At three years, distant metastasis-free rates are 33% and 89% in patients with and without regional lymph node metastasis respectively, and for dermal invasion, 51% and 92% for with and without respectively [14]. At five years, overall survival rates are 18% and 93% in patients with and without regional lymph node metastasis, and for dermal invasion, 47% and 100% for with and without respectively [14].…”

Paget'sdisease of scrotum and peniscase report of a re‐irradiation and review of the literature

“…According to this search strategy, 15 full-text articles, published between 1991 and 2019, were included in the final review. 10,[14][15][16][17][18][19][20][21][22][23][24][25][26][27] In order to summarize the available evidences, the following data were extracted from each report: authors, year of publication, tumor site, number of patients, treatment setting, intent of the treatment, dose and fractionation, RT technique, toxicity, and clinical outcome.…”

“…Conventional fractionation schemes were used (1.8-2.2 Gy per fraction) in 11 studies, with total delivered dose between 40 and 80.2 Gy. 10,[14][15][16][17][18]20,[24][25][26] Moderate hypofractionation (3-4.5Gy per fraction) schedules were used for a total delivered dose between 33 and 40.5 Gy in three studies. [21][22][23] Ultra-hypofractionation was used (6-10 Gy per fraction) for a total delivered dose between 30 and 36 Gy was used only in one case.…”