To evaluate a regimen of
radiochemotherapy as an alternative treatment for those patients with locally
advanced squamous cell carcinoma of the vulva.
Methods: Between July 1999 and February 2002, there were 11 patients
with the diagnosis of squamous cell carcinoma of the vulva. Nine patients were
stage IVA at presentation and 2 patients presented with stage III. All
patients had biopsy prior to the treatment, and were treated with
radiochemotherapy. Treatment included two cycles of chemotherapy with
mitomycin-c (12 mg/m2 on day 1) and fluorouracil (5FU 800-1,000 mg/m2 on day 1
through 4) in addition to radiotherapy. Total radiation doses to the vulva and
groins ranged from 45 to 70 Gy (median = 60), with pelvic doses of 45 to 60 Gy
(median = 50).
Results: There was a 100% overall response rate with complete responses
in 7 patients (63.6%). Moist desquamation was the most important acute
complication and required treatment interruptions in 2 patients. Among
patients with complete clinical response, there has been 1 recurrence with the
median follow-up of 8 months (2-21), and the time to progression was 5 months
for this patient.
Conclusion: This experience suggests that initial treatment with
radiation and chemotherapy may offer some patients with locally advanced
squamous cancer of the vulva an alternative to exenterative surgery and may
hold curative potential for some patients with surgically unresectable or
medically inoperable tumor.
