Abstract
Context: Vulvar cancer is one of the uncommon gynecological malignancies. Multimodality treatment
with surgery, radiotherapy, and chemotherapy are required for treatment of the disease.
Aims: The aim of the study was to evaluate clinical outcome in patients of carcinoma vulva,
treated at our institution. Subjects and Methods: This was a retrospective-cohort study done in 50 patients with squamous cell carcinoma
of the vulva, treated at our institution from January 2008 to December 2014. Data
were analyzed on the basis of age, stage, type of treatment received, and treatment-related
toxicity. Disease-free survival and overall survival were estimated. Statistical Analysis Used: Kaplan–Meier survival analysis and Chi-square test were used for statistical analysis.
Results: Majority of the patients (52%) had presented with Stage III disease. Thirty-six of
50 patients underwent surgery: simple vulvectomy – 2, radical vulvectomy – 34, bilateral
inguinal lymph node dissection was done in 32 patients, and 1 patient underwent ipsilateral-inguinal
lymph node dissection. Among 40 patients who received radiotherapy and eight patients
received palliative radiotherapy. Seventeen patients underwent intensity-modulated
radiotherapy (IMRT) and 15 patients received conventional radiotherapy. Significantly
less Grade 2 or more skin toxicity (P = 0.003) observed in patients who underwent IMRT. Among non-IMRT group, eight patients
required treatment break during radiation. At a median follow-up time of 25.5 months,
median overall survival was 31 months and median disease-free survival was 25 months.
About 42% patients were alive and free of disease at last follow-up. Conclusions: Modified radical vulvectomy with inguinal lymph node dissection followed by radiotherapy
is the mainstay of management of locally advanced carcinoma vulva. Using IMRT, we
could minimize the treatment related radiation toxicity and treatment breaks.
Key words
Radiotherapy - cancer - vulva
