[The results of primary radiotherapy in vaginal carcinoma].
BACKGROUND
Cancer of the vagina is the least frequent primary malignant tumor of the female genital tract except carcinoma of the fallopian tube. Radiation therapy is the preferred treatment in most cases.


METHODS
Between 1965 and 1991, 39 patients (median age 66 years) with primary carcinoma of the vagina were treated with radiation therapy at our clinic. The mean observation period was 37 months. Classification according to the FIGO yielded a stage I in 43%, stage II in 24%, stage III in 22% and stage IV in 11%. Histological differentiation resulted in 35 squamous cell carcinomas and 4 adenocarcinomas. In 69%, the tumor was found on the posterior or lateral wall of the vagina, in 43% it arose from the upper third of the vagina. Standard therapy consisted of combined brachy- and teletherapy. Most of the brachytherapy applications were performed with a radium source.


RESULTS
Median survival was 37 months, calculated according to the Kaplan-Meier method. The 5-year actuarial survival rate for all stages was 41% (stage 1: 62%, stage II: 44%, stage III: 25%). Sixty-eight percent of all patients achieved a complete remission, 19% a partial response. Significant prognostic factors were stage of disease and histological grading.


CONCLUSIONS
Our results demonstrate the value of radiation therapy for the treatment of primary carcinoma of the vagina. Combined treatment with both external beam radiation and brachytherapy should be preferred.
Schäfer
U
U
Klinik und Poliklinik für Strahlentherapie--Radioonkologie, Westfälische Wilhelms-Universität Münster.
Micke
O
O
Prott
F J
FJ
Kügler
R
R
Neff
A
A
Willich
N
N
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods / Q000706:statistics & numerical data; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003037:Cobalt Radioisotopes / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011867:Radioisotope Teletherapy / Q000379:methods / Q000706:statistics & numerical data; D011879:Radiotherapy Dosage; D011883:Radium / Q000008:administration & dosage; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014625:Vaginal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*
D003037:Cobalt Radioisotopes; D011883:Radium