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ORIGINAL ARTICLES
Chemoradiation for primary invasive squamous carcinoma of the vagina
  1. J. L. Dalrymple*,
  2. A. H. Russell†,
  3. S. W. Lee†,
  4. S. A. Scudder‡,
  5. G. S. Leiserowitz*,
  6. W. K. Kinney§ and
  7. L. H. Smith*
  1. * University of California at Davis, Medical Center, Division of Gynecologic Oncology, Sacramento, CA
  2. † Radiological Associates of Sacramento Medical Group, Sacramento, CA
  3. ‡ University of California at Davis, Medical Center, Division of Hematology/Oncology, Sacramento, CA
  4. § Permanente Medical Group, Sacramento, CA
  1. Address correspondence and reprint requests to: John L. Dalrymple, MD, University of California, Davis Medical Center, 4860 Y Street, Suite 2500, Sacramento, CA 95817. Email: john.dalrymple{at}ucdmc.ucdavis.edu

Abstract

Objective To report outcomes for patients with primary, invasive, squamous carcinoma of the vagina treated with chemoradiation.

Methods Between 1986 and 1996, 14 patients were treated with primary therapy consisting of synchronous radiation and chemotherapy. Patients were judged not to be surgical candidates based on tumor size, location, and concerns related to urinary, bowel, or sexual function. Three patients were FIGO stage I, ten patients stage II, and one patient stage III. Radiation consisted of teletherapy alone (six patients) or in combination with intravaginal brachytherapy (eight patients). Total radiation dose ranged from 5700 to 7080 cGy (median 6300 cGy). Chemotherapy consisted of 5-fluorouracil alone (seven patients), or with cisplatin (six patients) or mitomycin-C (one patient).

Results One patient failed locally at 7 months and died of disease at 11 months. Four patients died of intercurrent illness (46, 92, 104, 109 months) and nine are alive and cancer-free 74–168 months after treatment (median 100 months). There were no vesicovaginal or enterovaginal fistulae.

Conclusions Radiation with synchronous chemotherapy is an effective treatment for squamous carcinoma of the vagina. Cancer control outcomes compare favorably with previously published results employing higher dose radiation as monotherapy.

  • brachytherapy
  • chemotherapy
  • radiation therapy
  • vaginal neoplasms

http://dx.doi.org/10.1136/ijgc-00009577-200401000-00015

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