ESTRO 2023

Session Item

Saturday

May 13

09:00 - 10:00

Stolz 1

Gynaecology

Chair: , The Netherlands;

Co-Chair: Safia Yahiaoui, Tunisia

Session Type: Mini-Oral

Track: Clinical

Journey:

VULVAR CANCER EXCLUSIVE RADIOTHERAPY (OLDLADY 1.1): AIRO GYN, MITO AND MaNGO GROUPS Cooperation

, Italy

Presentation Number: MO-0052

Abstract

Abstract Title:

VULVAR CANCER EXCLUSIVE RADIOTHERAPY (OLDLADY 1.1): AIRO GYN, MITO AND MaNGO GROUPS Cooperation

Authors:

Luca Tagliaferri^1,1, Valentina Lancellotta¹, Martina Ferioli², Calogero Casà³, Brigida Pappalardi⁴, Clelia Teresa Delli Curti⁵, Concetta Laliscia⁶, Mariangela Boccardi⁷, Francesca Tortoreto³, Giorgia Garganese⁸, Gabriella Ferrandina⁹, Maria Antonietta Gambacorta¹, Alessio Giuseppe Morganti²

¹Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; ²Alma Mater Studiorum University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine – DIMES, Bologna, Italy; ³Fatebenefratelli Isola Tiberina - Gemelli Isola, U.O.C. di Radioterapia Oncologica, Rome, Italy; ⁴Fondazione IRCCS Istituto Nazionale dei Tumori, Radiotherapy Unit, Milan, Italy; ⁵Fondazione IRCCS Istituto Nazionale dei Tumor, Radiotherapy Unit, Milan, Italy; ⁶University of Pisa, Department of New Technologies and Translational Research, Division of Radiation Oncology, Pisa, Italy; ⁷Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Radiation Oncology Unit, Campobasso, Italy; ⁸Università Cattolica del Sacro Cuore, Dipartimento Universitario Scienze della Vita e Sanità Pubblica - Sezione di Ginecologia ed Ostetricia , Rome, Italy; ⁹ Università Cattolica del Sacro Cuore, Dipartimento Universitario Scienze della Vita e Sanità Pubblica - Sezione di Ginecologia ed Ostetricia , Rome, Italy

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Purpose or Objective

Vulvar cancer (VC) is a relatively uncommon type of gynaecologic cancer. VC patients require multidisciplinary evaluation for primary surgery and inguinal lymph node assessment, and potentially adjuvant radiation and/or chemotherapy [4-7]. Radiotherapy (RT) and/or chemotherapy may be considered for primary treatment instead of surgery in cases that would otherwise require radical surgery such as abdominal-perineal resection or exenterative procedures. The aim of this study was to define efficacy and safety of exclusive radiotherapy (RT) +/- chemotherapy in a large, real-world data set of patients with vulvar cancer (VC).

Material and Methods

Data was obtained retrospectively from VC patients treated with RT in seven Italian Radiation Oncology Centers between January 2010 and December 2021. All patients underwent radiotherapy (45 Gy external-beam radiotherapy/1.8 Gy per fraction) +/- chemotherapy on the pelvic area plus overdosage on gross tumor volume (GTV) and positive nodes. The primary study endpoint was the local control (LC), secondary endpoints were metastases free survival (MFS), overall survival (OS), and the rate and severity of acute toxicities.

Results

A total of 80 patients were included in the analysis, with a median age of 73.5 years (range 32-89). Thirty-five patients received a total dose ≥70Gy and 45 patients a total dose <70Gy (range 60-66Gy) on the GTV. On positive nodes, 44 patients got a total dose > 65 Gy and 27 patients received a total dose ranging between 45-60 Gy. Nine, twelve, forty-five and fourteen patients were Stage I, II, III and IV, respectively. Sixty-six patients (82.5%) and sixty (87.5%), respectively, achieved tumor and nodal full remission. With a median follow-up of 11 months (range 1-114 months), the 24-month actuarial LC rate, MFS and OS were 49%, 79.8%, and 53.8%, respectively. Acute toxicity was registered in 69 patients, with sixteen and ten cases of proctitis G1 and G2, respectively; twelve, eighteen, and one case of cystitis G1, G2, and G3; and five, forty-one, and twenty cases of skin toxicity G1, G2, and G3, respectively. Three and five patients, respectively, had lymphedema G1 and G2.

Conclusion

This observational multicenter study on vulvar cancer exclusive radiotherapy revealed a large variability of doses and treatment’s volumes achieving not quite satisfactory outcome results. For this neoplasm with a poor prognosis, further collaborative prospective research is needed to standardize the RT strategy.