Hitoshi Ikushima1, Masaru Wakatsuki2,3, Takuro Ariga4, Yuko Kaneyasu5,6, Sunao Tokumaru7,8, Fumiaki Isohashi9, Noriko Ii10, Takashi Uno11, Tatsuya Ohno12, Kokichi Arisawa13, Takafumi Toita4. 1. Department of Therapeutic Radiology, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 7708508, Japan. ikushima@tokushima-u.ac.jp. 2. Department of Radiology, Jichi Medical University, Shimotsuke, Japan. 3. National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan. 4. Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nakagami, Japan. 5. National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan. 6. Department of Radiation Oncology, Hiroshima University, Higashihiroshima, Japan. 7. Hyogo Ion Beam Medical Center, Tatsuno, Japan. 8. Department of Radiology, Saga University, Saga, Japan. 9. Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Japan. 10. Department of Radiation Oncology, Mie University Hospital, Tsu, Japan. 11. Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan. 12. Gunma University Heavy Ion Medical Center, Maebashi, Japan. 13. Department of Preventive Medicine, Tokushima University Graduate School, Tokushima, Japan.
Abstract
PURPOSE: Our aim was to assess the patterns of practice and treatment outcomes of definitive radiotherapy (RT) for vaginal cancer in Japan. MATERIALS AND METHODS: RT methods and outcomes of patients with vaginal cancer treated with definitive RT or chemoradiotherapy at 10 institutes of the Japanese Radiation Oncology Study Group between January 2000 and March 2010 were retrospectively evaluated. RESULTS: A total of 90 patients were enrolled in the study. The clinical stages were I, II, III, and IVA in 34, 36, 16, and 4 patients, respectively. Seventy patients were treated with three-dimensional conformal RT (3DCRT) and brachytherapy (BT), 12 with BT alone, and 8 with 3DCRT alone. Chemotherapy was administered to 29 patients. The 5-year overall survival and local control rates were 77 and 83% with a median follow-up period of 94 months for surviving or lost patients. The 5-year overall survival rates according to stage were 94, 71, 56, and 75% for stages I, II, III, and IVA, respectively. The 5-year local control rates according to stage were 94, 77, 74, and 75% for stages I, II, III, and IVA, respectively. Twenty-nine percent (6 of 21 patients) of local recurrences occurred between 5 and 10 years after RT. The 10-year local control rate of all patients was 71%. Significant prognostic factors for overall survival by univariate and multi-variate analyses were performance status, tumor size, and pelvic lymph node metastasis. Grade 3 late radiation morbidity of the rectum, pelvic bone, urinary bladder, and skin developed in 9% (8 of 90 patients). CONCLUSIONS: Good outcomes similar to those of cervical cancer can be achieved with definitive RT delivered by 3DCRT and/or BT for vaginal cancer. Long follow-up is necessary for a continuing risk of local recurrence after 5 years.
PURPOSE: Our aim was to assess the patterns of practice and treatment outcomes of definitive radiotherapy (RT) for vaginal cancer in Japan. MATERIALS AND METHODS: RT methods and outcomes of patients with vaginal cancer treated with definitive RT or chemoradiotherapy at 10 institutes of the Japanese Radiation Oncology Study Group between January 2000 and March 2010 were retrospectively evaluated. RESULTS: A total of 90 patients were enrolled in the study. The clinical stages were I, II, III, and IVA in 34, 36, 16, and 4 patients, respectively. Seventy patients were treated with three-dimensional conformal RT (3DCRT) and brachytherapy (BT), 12 with BT alone, and 8 with 3DCRT alone. Chemotherapy was administered to 29 patients. The 5-year overall survival and local control rates were 77 and 83% with a median follow-up period of 94 months for surviving or lost patients. The 5-year overall survival rates according to stage were 94, 71, 56, and 75% for stages I, II, III, and IVA, respectively. The 5-year local control rates according to stage were 94, 77, 74, and 75% for stages I, II, III, and IVA, respectively. Twenty-nine percent (6 of 21 patients) of local recurrences occurred between 5 and 10 years after RT. The 10-year local control rate of all patients was 71%. Significant prognostic factors for overall survival by univariate and multi-variate analyses were performance status, tumor size, and pelvic lymph node metastasis. Grade 3 late radiation morbidity of the rectum, pelvic bone, urinary bladder, and skin developed in 9% (8 of 90 patients). CONCLUSIONS: Good outcomes similar to those of cervical cancer can be achieved with definitive RT delivered by 3DCRT and/or BT for vaginal cancer. Long follow-up is necessary for a continuing risk of local recurrence after 5 years.
Entities:
Keywords:
Brachytherapy; Chemoradiotherapy; Radiotherapy; Vaginal cancer
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