Long-term follow-up in radiation therapy of carcinoma of the vagina

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Abstract
A retrospective analysis of 134 patients with histologically confirmed carcinoma of the vagina is reported. Actuarial disease free 5-year survival was: Stage 0 (15 patients), 90%; I (39 patients), 90%; IIA (39 patients), 58%; IIB (21 patients), 32%; III (12 patients), 40%; IV (8 patients), 0%. Fifteen patients had carcinoma in situ; of these, 14 were controlled with interstitial or intracavitary therapy. Of 39 patients with Stage I carcinoma, 37 (95%) showed no evidence of vaginal or pelvic recurrence. Most of them received interstitial or intracavitary therapy or both; the addition of external beam irradiation did not significantly increase survival or tumor control. In Stage IIA (paravaginal extension) 22 of 34 (64.7%) patients were controlled with a combination of brachytherapy and external beam irradiation; only two of five (40%) treated with brachytherapy alone exhibited tumor control in the pelvis. Eight of 12 Stage III tumors were controlled in the pelvis. Only two of eight patients with Stage IV had no recurrence in the pelvis even with relatively high doses of irradiation. The dose of irradiation delivered to the primary tumor or the parametrial extension was critical in achieving successful results. The incidence of complications (9.7%) is correlated with the stage of the tumor and type of treatment given.

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