Chemoradiation for primary invasive squamous carcinoma of the vagina.
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.
Dalrymple
J L
JL
University of California at Davis, Medical Center, Division of Gynecologic Oncology, Sacramento, CA 95817, USA. john.dalrymple@ucdmc.ucdavis.edu
Russell
A H
AH
Lee
S W
SW
Scudder
S A
SA
Leiserowitz
G S
GS
Kinney
W K
WK
Smith
L H
LH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001918:Brachytherapy; D002140:California / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008499:Medical Records; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D014625:Vaginal Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy