Neoadjuvant chemotherapy in advanced vulvar cancer.
BACKGROUND
Locally advanced tumors of the vulva represent approximately one third of all vulvar cancers. Therapeutic options include chemoradiation, radiotherapy, and neoadjuvant chemotherapy (NACT).


METHODS
Analysis of 3 NACT schemes, bleomicine, paclitaxel, and 5-fluorouracil/cisplatin, used in patients with locally advanced vulvar tumors in a 12-year period. The following parameters were evaluated and compared between regimens: age, initial tumor size, inguinal involvement, histological type, toxicities, response to treatment, surgery performed after NACT, and overall survival.


RESULTS
Of the 25 patients included, 10 underwent an NACT regimen with bleomicine (Group A); 5, with paclitaxel (Group B); and 10, with a combination of 5-fluorouracil/cisplatin (Group C). In Group A, there was a 60% response rate. Mortality was 70%, with an overall survival rate of 70%, 40%, and 30% at 12, 24, and 60 months, respectively. The mean (SD) survival was 46.7 (15.4) months. In Group B, the response rate was 40%, with an 80% mortality rate and a survival rate of 60% and 20% at 12 and 24 months, respectively. The mean (SD) survival was 17.0 (3.8) months. In Group C, 20% of the responses were observed and the mortality was 90%, with an overall survival rate of 10% at 12 and 24 months and a mean (SD) survival of 7.6 (2.0) months.


CONCLUSIONS
The best response and overall survival rates were achieved in Group A with the NACT scheme of bleomicine.
Domingues
Ana Patrícia
AP
Gynecology Department, Coimbra University Hospitals, Coimbra, Portugal. anapatriciadomingues@hotmail.com
Mota
Fernando
F
Durão
Marta
M
Frutuoso
Cristina
C
Amaral
Natália
N
de Oliveira
Carlos Freire
CF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000627:therapeutic use; D011174:Portugal / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000401:mortality
D000970:Antineoplastic Agents; D001761:Bleomycin; D017239:Paclitaxel; D002945:Cisplatin; D005472:Fluorouracil