Radiotherapy alone and chemoirradiation in recurrent squamous cell carcinoma of the vulva

To evaluate the role of radiotherapy alone or combined with chemotherapy in the treatment of recurrent vulvar cancer, emphasising the prognostic factors and outcomes.

Twenty women with loco-regional recurrence of vulvar carcinoma were retrospectively reviewed. Eleven patients were managed with a combination of chemotherapy and radiotherapy, seven out of these with concomitant radio-chemotherapy and four with neo-adjuvant chemotherapy. Nine patients were submitted to radiotherapy alone. The total dose of radiation therapy ranged from 30 Gy to 70 Gy.

The median follow-up was 6 months (range 2-70 months). The 5-year overall and disease-free survival for the entire cohort was 20%. The outcomes included 6 complete response (CR), 10 partial response (PR) and 4 no change (NC). Patients with one site of recurrence and size of lesion < or = 3 cm were long survivors and disease-free at 5 years; all these women received a total dose of radiation therapy > or = 6480 cGy.

We emphasize the importance of the number, site and diameter of recurrences as prognostic indicators; the outcomes of these patients were also affected by the total dose of radiation therapy.