title: Brachytherapy as part of the conservative treatment for primary and recurrent vulvar carcinoma.
abstract: There are only scarce data on the place of brachytherapy (BT) for treatment of vulvar carcinoma. Our institutional experience of interstitial BT for vulvar carcinoma patients is reported.
  
  
  
  Clinical records of patients receiving low-dose-rate or pulsed-dose-rate BT as part of the primary treatment for primary/recurrent vulvar squamous cell carcinoma or as part of postoperative treatment between 2000 and 2015 were included. Patients, tumors, and treatment characteristics as well as clinical outcome were examined.
  
  
  
  A total of 26 patients treated with BT were identified. BT was delivered as part of primary intent treatment for locally advanced/recurrent cancer in 11 patients and as part of postoperative treatment in 15 patients. Median age at time of BT was 63 years (range, 41-88 years). Pulsed-dose-rate and low-dose-rate were used in 15 patients and 11 patients, respectively. BT was performed as a boost to the tumor bed following external beam radiotherapy (n = 13) or as the sole irradiation modality (n = 13). Total median dose at the level of primary tumor was 60 GyEQD2 (range, 55-60 GyEQD2). With mean followup of 41 months (range, 5 months-11.3 years), 11 patients experienced tumor relapse, and in two of them, site of relapse was only local. Three-year estimated disease-free survival and overall survival rates were 57% (95% confidence interval: 45-69%) and 81% (95% confidence interval: 72-90%), respectively. All toxicities were Grade 2 or less.
  
  
  
  Interstitial BT used as part of the primary or postoperative treatment of vulvar carcinoma is feasible with a satisfactory toxicity profile. Prognosis remains, however, dismal, with a high frequency of failures in patients with locally advanced tumors.
authors.affiliation: Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: P
authors.initials: P
authors.lastname: Castelnau-Marchand
authors.affiliation: Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Escande
authors.affiliation: Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: R
authors.initials: R
authors.lastname: Mazeron
authors.affiliation: Department of Surgery, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: E
authors.initials: E
authors.lastname: Bentivegna
authors.affiliation: Department of Surgery, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Cavalcanti
authors.affiliation: Department of Surgery, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: S
authors.initials: S
authors.lastname: Gouy
authors.affiliation: Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: C
authors.initials: C
authors.lastname: Baratiny
authors.affiliation: Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: P
authors.initials: P
authors.lastname: Maroun
authors.affiliation: Department of Surgery, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: P
authors.initials: P
authors.lastname: Morice
authors.affiliation: Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France.
authors.forename: C
authors.initials: C
authors.lastname: Haie-Meder
authors.affiliation: Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France; French Military Health Services Academy, Paris, France; Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France. Electronic address: cyrus.chargari@gustaveroussy.fr.
authors.forename: C
authors.initials: C
authors.lastname: Chargari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D000072700:Conservative Treatment; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D015996:Survival Rate; D014846:Vulvar Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery
keywords: Brachytherapy; Low dose rate; Pulse dose rate; Vulvar carcinoma