Interstitial brachytherapy in the treatment of advanced and recurrent vulvar cancer.
OBJECTIVE
Our purpose was to evaluate the role of interstitial brachytherapy in vulvar cancer management.


METHODS
From 1985-1992 we performed a retrospective study of patients treated at the University of California, Irvine Medical Center, and Long Beach Memorial Medical Center.


RESULTS
Eleven patients received interstitial brachytherapy, with (n = 5) or without (n = 6) external beam radiotherapy, for locally advanced (n = 5) or recurrent (n = 6) vulvar cancer. Local control was achieved in all patients. Ten patients have died of disease at a mean interval of 33 months from the time of treatment, with 9 patients having maintenance of local control at death. One patient is alive without disease after 77 months of follow-up. There were 2 cases of local necrosis (18%) and 1 case of rectovaginal fistula (9%).


CONCLUSIONS
Local control of advanced vulvar cancer can be achieved with interstitial brachytherapy, with or without external beam radiotherapy. With improved systemic therapy this treatment modality may be used to salvage women with bulky, symptomatic tumors.
Division of Gynecologic Oncology, University of California, Irvine Medical Center, Orange, California, USA.
K
K
Tewari
F
F
Cappuccini
A M
AM
Syed
A
A
Puthawala
P J
PJ
DiSaia
M L
ML
Berman
A
A
Manetta
B J
BJ
Monk
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008545:Melanoma / Q000532:radiotherapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000532:radiotherapy*