High-dose-rate brachytherapy in primary stage I and II vaginal cancer

Thirteen patients with primary vaginal cancer were treated with external beam irradiation and high-dose-rate brachytherapy. Median age was 65 years old. Five tumors were stage I, 4 stage IIA, and 4 stage IIB. Twelve tumors were squamous and 11 were moderately or poorly differentiated. Median tumor diameter was 4 cm. Patients were treated with external beam irradiation (4500 cGy) and high-dose-rate brachytherapy (2000-2800 cGy in three to four fractions). All 13 patients had a complete response. Local control was achieved in 12 patients (92%) at a median follow-up of 2.6 years. No acute or chronic intestinal or bladder grade 3 or 4 toxicity was observed. Moderate to severe vaginal stenosis occurred in 6 patients (46%). Treatment of stage I and II primary vaginal cancer with external beam irradiation and high-dose-rate brachytherapy appears to produce a high response rate, local control, and survival with minimal complications.