[Therapy of vulvar carcinoma]

Thirty-five of totally 50 patients with carcinoma vulvae were treated with bleomycin. Most of the patients were older people and had more advanced disease. They were grouped according to the TNM system and the age. Bleomycin alone (2 X 15 mg/m2 weekly; 390 and 420 mg total dose) was given to two patients. One of the patients had a complete remission and the other one a partial remission with reduction in tumor size of more than 50%. Nineteen patients received bleomycin (2 X 10 up to 2 X 15 mg/m2 weekly: 200-300 mg total dose) in combination with radiation therapy using fast electrons (betatron; 3000-5000 R). In this group 21,1% of the patients had complete remission and 31,5% of patients had a partial remission of more than 50% tumor size reduction (objective remission rate 52,6%). Bleomycin was also beneficial when combined with surgery plus irradiation. Palliative irradiation was used in four patients with a very advanced disease. Eleven patients were irradiated postoperatively with fast electrons (4000-6000 R). In this group, 65% of the patients were free from recurrences more than one year after the beginning of the treatment. Our results indicate that combined therapies using bleomycin, surgery and radiation therapy were more effective in the treatment of vulvar carcinoma than single treatments alone. It should be emphasized that bleomycin is effective as a palliative treatment of squamous cell carcinoma of the vulva.