title: Radiotherapy in patients with extramammary Paget's disease--our own experience and review of the literature.
abstract: BACKGROUND
  There are few reports on radiotherapy methods for treating extramammary Paget's disease (EMPD). The aim of this study was to explore the outcome of radiotherapy for EMPD.
  
  
  METHODS
  Between June 1995 and October 2010, 14 patients with EMPD (7 male and 7 female; median age 77 years) underwent radiotherapy at the Tokyo Medical University Hospital. The median total irradiation dose was 50 Gy, delivered in 20-33 fractions. Case reports of patients with EMPD were obtained from the PubMed database for the period of 1991-2012. 66 patients (median age 73 years) were identified. Radiotherapy outcomes were analyzed.
  
  
  RESULTS
  All patients achieved complete response within the irradiated volume during a median observation period of 71.4 months. The 5-year locoregional progression-free survival and overall survival were 91.7% (95% confidence interval (CI) 53.9-98.8%) and 84.3% (95% CI 50.3-95.8%), respectively. From the PubMed database, the 5-year local progression-free survival and locoregional progression-free survival were 84.5% (95% CI 65.3-93.6%) and 77.5% (95% CI 57.3-89.0%), respectively. 12 (18%) patients had a recurrence in the inguinal lymph nodes.
  
  
  CONCLUSIONS
  Radiotherapy yielded good local control and survival, which suggests that it was effective for patients with EMPD and in particular medically inoperable EMPD.
authors.affiliation: Department of Radiology, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Itonaga
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Nakayama
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Okubo
authors.forename: Ryuji
authors.initials: R
authors.lastname: Mikami
authors.forename: Sachica
authors.initials: S
authors.lastname: Nogi
authors.forename: Yu
authors.initials: Y
authors.lastname: Tajima
authors.forename: Shinji
authors.initials: S
authors.lastname: Sugahara
authors.forename: Koichi
authors.initials: K
authors.lastname: Tokuuye
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000517:prevention & control*; D018365:Neoplasm, Residual; D010145:Paget Disease, Extramammary / Q000175:diagnosis* / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome