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Low-dose mitomycin C, etoposide, and cisplatin for invasive vulvar Paget's disease
Yoh Watanabe1, H Hoshiai, H Ueda
1Department of Obstetrics and Gynecology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka 589-8511, Japan. watanabe@med.kindai.ac.jp
Abstract:
We report the effect of low-dose mitomycin C, etoposide, and cisplatin (low-dose MEP) therapy for three patients with invasive vulvar Paget's disease (invasive VPD) who declined radical vulvectomy and skin grafting. One patient achieved a complete response, while the other two showed partial responses (PR) without grade 3 or 4 adverse effects. The two patients with PR were undergone partial vulvectomy and inguinal lymph node dissection. All patients have no sign of recurrence for 10 months after chemotherapy. Our present results suggest that low-dose MEP is an effective and safe chemotherapy for invasive VPD and low-dose MEP may significantly improve postoperative quality of life in patients with invasive VPD by avoiding extensive vulvar resection and skin grafting.
Insights
Low-dose mitomycin C, etoposide, and cisplatin (MEP) chemotherapy offers a safe and effective treatment for invasive vulvar Paget
Area of Science:
- Oncology
- Gynecologic Oncology
- Chemotherapy
Background:
- Invasive vulvar Paget's disease (VPD) is a rare malignancy.
- Radical vulvectomy and skin grafting are standard treatments but can significantly impair quality of life.
- Alternative treatment options are needed for patients declining extensive surgery.
Observation:
- Three patients with invasive VPD who declined radical surgery were treated with low-dose MEP chemotherapy.
- One patient achieved a complete response.
- Two patients achieved partial responses with no severe adverse effects.
Findings:
- Low-dose MEP chemotherapy demonstrated efficacy in treating invasive VPD.
- The treatment regimen was well-tolerated, with no grade 3 or 4 adverse events observed.
- Patients with partial responses underwent subsequent partial vulvectomy and lymph node dissection, with no recurrence at 10 months.
Implications:
- Low-dose MEP chemotherapy is a viable and safe alternative for invasive VPD.
- This approach may preserve quality of life by avoiding extensive vulvar resection and skin grafting.
- Further research into low-dose MEP for invasive VPD is warranted.