Radiation therapy for primary vaginal carcinoma.

Area of Science:

• Oncology
• Radiation Oncology
• Gynecologic Oncology

Background:

• The role of brachytherapy in vaginal cancer management is not well-defined, unlike its established use in cervical cancer.
• This study reviews institutional experience to clarify brachytherapy's significance in primary invasive vaginal carcinoma.

Purpose of the Study:

• To evaluate the effectiveness of brachytherapy in treating primary vaginal cancer.
• To determine the local control rates, disease-free survival, and overall survival in patients treated with various radiation modalities.

Main Methods:

• Retrospective review of 36 patients with primary vaginal carcinoma treated between 1992 and 2010.
• Treatment modalities included high-dose-rate intracavitary brachytherapy (HDR-ICBT), external beam radiation therapy (EBRT), or combinations, including high-dose-rate interstitial brachytherapy (HDR-ISBT).

Main Results:

• Two-year local control rate (LCR) was 68.8%, disease-free survival (DFS) was 55.3%, and overall survival (OS) was 73.9%.
• LCR varied significantly by stage (Stage I: 100%, Stage IV: 0%; P = 0.007).
• For T2-T3 disease, HDR-ISBT showed a trend towards improved 5-year LCR (88.9% vs 46.9%, P = 0.064).

Conclusions:

• Brachytherapy can be a central component of radiation therapy for primary vaginal cancer.
• Combining external beam radiation therapy with HDR-ISBT for T2-T3 vaginal cancer appears to yield good local control.
• Treatment-related toxicities were generally low grade.