Twenty-year review of radiotherapy for vaginal cancer: an institutional experience.
OBJECTIVE
To evaluate clinical outcome, prognostic factors and chronic morbidity with radiotherapy for vaginal cancer treatment.


METHODS
68 patients with vaginal cancer treated by radical or adjuvant radiotherapy (RT) were selected. Five with rare subtypes of histopathology and 8 with adenocarcinoma were excluded from this study. 76.4% of the remainder had early-stage diseases (stage I: 14, II: 28, III: 9, and IV: 4). The patients in the years from which they were treated were almost evenly distributed (1st 5 years: 13, 2nd: 14, 3rd: 16, and 4th: 12). There were four treatment groups: external beam radiotherapy (EBRT) alone (n=18), brachytherapy (BT) alone (n=4), EBRT and BT (n=30), and surgery plus RT (n=3).


RESULTS
Median follow-up was 50.3 months ranging from 3 to 213 months. 5-year overall survival (OS) was 55.6%, disease-specific survival (DSS) was 77.3%, disease-free survival was 74.2%, and local control was 87.7%. Independent prognostic factors for DSS and OS were tumor stage, site and size (p<0.05). Late radiation toxicity was minimal in the bladder (4.6%) and bowel (4.6%). Vaginal morbidity was observed in 35 patients (63.6%). It was lowest in the BT alone (0%), and highest in the EBRT and BT group (82.1%), especially for those received more than 70 Gy (p=0.05, Odds ratio=4.64, 95% confidence interval: 1.01-21.65).


CONCLUSIONS
This retrospective review suggested that tumor stage, site, and size were important prognostic factors in patients with vaginal cancer. Higher radiation dose was associated with more frequent vaginal toxicity.
Lian
Jidong
J
Department of Radiation Oncology, Cross Cancer Institute and University of Alberta, Edmonton, Canada.
Dundas
George
G
Carlone
Marco
M
Ghosh
Sunita
S
Pearcey
Robert
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D014625:Vaginal Neoplasms / Q000473:pathology / Q000532:radiotherapy*