局灶性晚期外阴癌术前放、化疗

作     者：Gerszten K Selvaraj R.N Kelley J Faul C 朱亮 

作者机构：Department of Radiation Oncology University of Pittsburgh Cancer Institute UPMC Cancer Pavillon (POB II) 5150 Centre Avenue Pittsburgh PA 15232 United States 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2006年第2卷第5期

页      面：35-35页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：腹股沟淋巴结 局部淋巴结 尿嘧啶 毒性反应 妇科肿瘤 原发瘤 临床反应 会阴皮肤 原发肿瘤 临床病理 

摘      要：A twice daily (BID) radiation treatment schedule (interval of 4- 6 h) delivered concurrent with chemotherapy for advanced or critically located carcinoma of the vulva was modeled on the schema developed by the Gynecology Oncology Group (GOG). Inguinal nodes were included in the treatment fields even if clinically negative. This review analyzed the outcomes using this approach. Methods. A retrospective review was conducted of the records of 18 patients with vulvar cancer. Patients were treated with a modified GOG schema using 5- fluorouracil (5FU) and cisplatin with BID radiation treatments during the first and last weeks of treatment and seven daily radiation treatments in between. The regional nodes and primary tumor were prescribed 44.6 Gy. Resection of the primary tumor bed and inguinal dissection was planned at 4- 6 weeks post-treatment. Clinical and pathological responses as well as locoregional control and toxicity were assessed. Results. All patients responded. There were 13/18 complete clinical responses (cCR), of whom 12 remained NED at 25 months. Of the five partial clinical response (cPR) patients, two have suffered local recurrences, despite surgical resection in one and electron boost in the other. All patients developed a desquamative perineal skin reaction necessitating a mean treatment break of 15 days. No severe hematological toxicity was encountered, and only one patient had grade 3 small bowel toxicity. One patient required surgical debridement for groin wound breakdown. Conclusion. The use of BID chemoradiation resulted in complete or partial responses in all cases. Post-treatment groin dissection can be performed without significant post-operative complications.