title: Preliminary results of chemoradiation as a primary treatment for vulvar carcinoma.
abstract: OBJECTIVE
  To assess the role of chemoradiation as a primary treatment for vulvar carcinoma.
  
  
  METHODS
  Between December 1989 and August 1997, there were 14 patients with the diagnosis of squamous cell carcinoma of the vulva. Two patients were excluded from this study because of advanced stage at presentation. Key information about the remaining 12 patients was extracted from their charts. All patients had biopsy prior to treatment, and were treated with chemoradiation. Radiation was administered to the vulva only. Surgical biopsies from the vulva and inguinal nodal dissection were done 4-6 weeks after radiation treatment. All patients were followed for evaluation of response and clinical detection of recurrence. The period of follow-up ranged from 8 to 125 months. Mean follow-up period was 41 months.
  
  
  RESULTS
  All 12 patients showed complete response to the treatment. Only 1 patient (8.3%) developed local recurrence at 3 months posttreatment. Another patient (8.3%) developed nodal recurrence at 30 months posttreatment. Both patients were salvaged by surgical treatment and remained disease free. The actuarial 5-year disease-free survival was 43%. The actuarial 3-year disease-free survival was 84%. The majority of patients developed mild-to-moderate complications due to chemoradiation. These were well tolerated and responded to medical treatment. None of the patients developed late complications to chemoradiation treatment.
  
  
  CONCLUSIONS
  Chemoradiation is an effective primary treatment for vulvar carcinoma as shown by these successfully managed cases.
authors.affiliation: Department of Radiation Oncology, Hurley Medical Center, Flint, MI 48503-5993, USA. aak11@hurleymc.com
authors.forename: A
authors.initials: A
authors.lastname: Akl
authors.forename: M
authors.initials: M
authors.lastname: Akl
authors.forename: G
authors.initials: G
authors.lastname: Boike
authors.forename: J
authors.initials: J
authors.lastname: Hebert
authors.forename: J
authors.initials: J
authors.lastname: Graham
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009367:Neoplasm Staging; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D016685:Mitomycin; D005472:Fluorouracil