Records of 44 patients with vulvar SCC treated with concurrent chemotherapy and radiation (chemoRT) from 1988 to 2008 were reviewed. Rates of disease-free survival (DFS), overall survival (OS), locoregional recurrence (LRR), and distant metastases (DM) were estimated using the Kaplan–Meier method.
The median age was 63 years (range, 44–90), 84.1 % of patients had ECOG performance status 0–1, and patients had FIGO Stage II (n = 6), III (n = 31), or IVA (n = 7) disease. Patients were treated preoperatively (n = 10), postoperatively (n = 10), or without surgery (n = 24). The median RT dose to the vulva was 50.2 Gray (range, 22–75). Concurrent chemotherapy regimens included weekly platinum (n = 16) or every 3–4 week regimens with 5-FU as the backbone (n = 28).
With a median follow-up of 31.5 months, there was no significant difference in 2-year OS (74.5 % vs. 70.0 % ; p = 0.65), DFS (61.9 % vs. 56.0 % ; p = 0.85), LRR (31.3 % vs. 32.9 % ; p = 0.93), or DM (6.3 % vs. 10.6 % ; p = 0.81) between the weekly platinum and every-3–4-week 5-FU regimens. Twenty patients (45.4 % ) recurred: 16 LRR, 2 DM, and 2 with both. The clinical and pathologic complete response rates were 58.8 % (20/34), and 53.8 % (14/26), respectively. There was a higher proportion of grade 3 or higher acute non-skin toxicities in patients receiving every-3–4-week 5-FU (46.1 % vs. 13.3 % ; p = 0.07), but more grade 3 or higher skin toxicity in patients receiving weekly platinum (62.5 % vs. 32.0 % ; p = 0.01).
OS, response rates, and recurrence rates were not significantly different after RT with concurrent weekly platinum-based versus every-3–4-week regimens containing 5-FU for vulvar SCC.