Synchronous radiation and cytotoxic chemotherapy for locally advanced or recurrent squamous cancer of the vulva

Surgery and radiotherapy in vulvar cancer

“…Radiotherapy with or without chemotherapy has also proven its efficacy in the treatment of vulvar cancer. Collated literature data show a somewhat lower local control rate of 40% after chemoradiotherapy compared with surgery [128][129][130][131][132][133][134] (Table 5). Radiotherapy in moderate doses combined with chemotherapy, followed by organ sparing surgery has shown its efficacy in preventing stoma formation [135].…”

Old and new perspectives in the management of high-risk, locally advanced or recurrent, and metastatic vulvar cancer

“…Whereas the association of BLEO and irradiation was disappointing [109,110], the use of radiotherapy combined with single-agent 5-FU or 5-FU + MMC [111][112][113][114][115][116][117][118] (Tables 3 and 4) or with 5-FU + CDDP [72,100,[119][120][121][122][123][124][125][126] (Tables 5 and 6) has given promising results. Chemotherapy started at the first day of irradiation and was usually repeated after 4 weeks.…”

“…With combined CDDP, 5-FU, and irradiation, Russell et al [120] achieved a clinical complete response in 16 (88.9%) out of 18 patients with locally advanced disease and in 4 (51.7%) out of the 7 patients with recurrent disease. Three (15%) out of the 20 complete responders relapsed within the irradiated areas at 11, 38, and 48 months, respectively.…”

Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva

“…The median hospital stay for patients undergoing surgery was 18 days (IQR, [15][16][17][18][19][20][21][22][23][24]. Postoperative follow-up revealed necrosis in 3 (14.3%) cases, breakdown of groin wounds in 3 (14.3%), breakdown of vulvar wounds in 7 (31.8%), lymphocele in 14 (63.6%) and chronic lymphedema in 14 (63.6%).…”

“…A number of retrospective analyses have established the feasibility of this new therapeutic approach, and suggested a therapeutic benefit of induction chemoradiation therapy for the treatment of vulvar neoplasms (2,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The majority of studies involved patients with locally advanced vulvar neoplasms, but certain studies also included recurrent tumor cases that were not eligible for surgical resection by radical vulvectomy.…”