Survival and failure types after radiation therapy of vulvar cancer

• Main Authors: Christina Steen Vorbeck, Ivan Richter Vogelius, Marie Louise Vorndran Cøln Banner-Voigt, Hanne From Mathiesen, Mansoor Raza Mirza
• Format: Article
• Language: English
• Published: Elsevier 2017-08-01
• Series: Clinical and Translational Radiation Oncology
• Subjects: Vulvar cancer; Chemoradiation; Radiation; Failure types; Elderly
• Online Access: http://www.sciencedirect.com/science/article/pii/S2405630817300034

Background and purpose: Describe the survival rates and distribution of events on competing failure types in vulvar carcinoma after treatment with chemoradiation (CRT) or radiation (RT) alone. Material and methods: We included patients with vulvar carcinoma treated with CRT or RT between 2009 and 2014. Survival was estimated using the Kaplan-Meier method. We performed a competing risk analysis and included five competing events: loco-regional failure (LRF), distant metastasis, LRF plus distant metastasis, and death without evidence of disease, with the remaining patients denoted alive without evidence of disease. Results: 87 patients were treated. Progression free survival (PFS) and overall survival (OS) at 3 years were 40% and 57%, respectively. 41.3% of patients relapsed, most often loco-regionally. We saw significantly worse PFS and OS for patients older than 68 (p = 0.011/p = 0.010) and for patients treated with definitive RT (p = 0.004/p = 0.005). Competing risk analysis showed increased risk of LRF, and that death was most often related to vulvar cancer. Death without disease recurrence was less frequent, even in the elderly. Conclusions: LRF was the most common event. PFS and OS were inferior for elderly patients and patients treated definitively. A better understanding of these differences may be used to define risk adapted treatment strategies.