Neoadjuvant chemotherapy followed by radical surgery in patients affected by vaginal carcinoma.
BACKGROUND
Radiotherapy represents the standard treatment for patients affected by FIGO stage II vaginal cancer. Several authors have suggested that neoadjuvant chemotherapy followed by radical surgery might be a valid treatment option in patients affected by cervical cancer. The objective of this study was to analyse the feasibility and results obtained by neoadjuvant chemotherapy followed by surgery in patients affected by invasive vaginal cancer with paravaginal tissue involvement not reaching the pelvic side wall.


METHODS
Eleven patients affected by FIGO stage II vaginal cancer were treated with paclitaxel 175 mg/m(2) and cisplatin 75 mg/m(2) every 21 days for three courses followed by radical surgery.


RESULTS
All patients were subjected to the 3 planned chemotherapy courses. Three (27%) patients achieved a complete clinical response and seven (64 %) patients achieved a partial clinical response. All patients were subjected to radical hysterectomy and vaginectomy. At a median follow up of 75 months two (18%) patients suffered a disease recurrence and one of these died of disease.


CONCLUSIONS
Neoadjuvant chemotherapy followed by radical surgery is a feasible therapeutic strategy with good short- and long-term results. In women affected by vaginal cancer, a larger series reporting the result of this therapeutic strategy or the results obtained by surgery alone will aid physicians to choose the best therapeutic strategy for each individual patient.
Benedetti Panici
Pierluigi
P
Department of Obstetrics and Gynecology, University of Rome "La Sapienza", Viale del Policlinico, 155, Rome, Italy.
Bellati
Filippo
F
Plotti
Francesco
F
Di Donato
Violante
V
Antonilli
Morena
M
Perniola
Giorgia
G
Manci
Natalina
N
Muzii
Ludovico
L
Angioli
Roberto
R
D000328:Adult; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis; D014625:Vaginal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel