Difference between revisions of "Vulvar cancer"
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=Guidelines= | =Guidelines= | ||
− | ==[https://www.nccn.org/ NCCN] | + | '''Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.''' |
− | *[https:// | + | ==NCCN== |
+ | *[https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1476 NCCN Guidelines - Vulvar Cancer] | ||
+ | **'''2017:''' Koh et al. [https://doi.org/10.6004/Jnccn.2017.0008 Vulvar Cancer, Version 1.2017, NCCN Clinical Practice Guidelines in Oncology.] [https://pubmed.ncbi.nlm.nih.gov/28040721/ PubMed] | ||
=Neoadjuvant therapy= | =Neoadjuvant therapy= | ||
==Cisplatin & RT {{#subobject:89c649|Regimen=1}}== | ==Cisplatin & RT {{#subobject:89c649|Regimen=1}}== | ||
− | + | Cisplatin & RT: Cisplatin & '''<u>R</u>'''adiation '''<u>T</u>'''herapy | |
− | + | <div class="toccolours" style="background-color:#eeeeee"> | |
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− | RT: '''<u>R</u>'''adiation '''<u>T</u>'''herapy | ||
===Regimen {{#subobject:63d249|Variant=1}}=== | ===Regimen {{#subobject:63d249|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Dates of enrollment |
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1016/j.ygyno.2011.11.003 Moore et al. 2011] |
− | | style="background-color:#91cf61" |Phase | + | |2005-01-19 to 2009-09-21 |
+ | | style="background-color:#91cf61" |Phase 2 | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Cisplatin (Platinol)]] 40 mg/m<sup>2</sup> IV once per | + | *[[Cisplatin (Platinol)]] 40 mg/m<sup>2</sup> IV once per day on days 1, 8, 15, 22, 29, 36, 43 |
====Radiotherapy==== | ====Radiotherapy==== | ||
− | *Concurrent [[External_beam_radiotherapy|radiation therapy]] | + | *Concurrent [[External_beam_radiotherapy|radiation therapy]] 180 cGy per day on days 1 to 5, 8 to 12, 15 to 19, 22 to 26, 29 to 33, 36 to 40, 43, 44 (32 fractions, for a dose of 5760 cGy) |
− | + | '''6.5-week course''' | |
− | ''' | + | </div> |
+ | <div class="toccolours" style="background-color:#cbd5e7"> | ||
====Subsequent treatment==== | ====Subsequent treatment==== | ||
*[[Surgery#Surgical_resection|Surgical resection]] of residual disease (or biopsy to confirm CR) | *[[Surgery#Surgical_resection|Surgical resection]] of residual disease (or biopsy to confirm CR) | ||
− | + | </div></div> | |
===References=== | ===References=== | ||
− | # Moore DH, Ali S, Koh WJ, Michael H, Barnes MN, McCourt CK, Homesley HD, Walker JL. A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a Gynecologic Oncology Group study. Gynecol Oncol. 2012 Mar;124(3):529-33. Epub 2011 Nov 9. [https:// | + | # Moore DH, Ali S, Koh WJ, Michael H, Barnes MN, McCourt CK, Homesley HD, Walker JL. A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a Gynecologic Oncology Group study. Gynecol Oncol. 2012 Mar;124(3):529-33. Epub 2011 Nov 9. [https://doi.org/10.1016/j.ygyno.2011.11.003 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/22079361/ PubMed] |
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=Locally advanced or metastatic disease= | =Locally advanced or metastatic disease= | ||
''Due to its relative rarity, there are very few prospective trials in advanced and metastatic vulvar cancer. In clinical practice, many adopt regimens from the cervical cancer literature; see the [[Cervical_cancer|cervical cancer page]] for those regimens.'' | ''Due to its relative rarity, there are very few prospective trials in advanced and metastatic vulvar cancer. In clinical practice, many adopt regimens from the cervical cancer literature; see the [[Cervical_cancer|cervical cancer page]] for those regimens.'' | ||
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==Paclitaxel monotherapy {{#subobject:635f43|Regimen=1}}== | ==Paclitaxel monotherapy {{#subobject:635f43|Regimen=1}}== | ||
− | + | <div class="toccolours" style="background-color:#eeeeee"> | |
− | |||
− | |||
− | |||
===Regimen {{#subobject:723bf0|Variant=1}}=== | ===Regimen {{#subobject:723bf0|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Dates of enrollment |
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731017/ Witteveen et al. 2009] | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731017/ Witteveen et al. 2009 (EORTC 55985)] |
− | |style="background-color:#91cf61"|Phase | + | |2001-02 to 2004-12 |
+ | |style="background-color:#91cf61"|Phase 2 | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
*[[Paclitaxel (Taxol)]] 175 mg/m<sup>2</sup> IV once on day 1 | *[[Paclitaxel (Taxol)]] 175 mg/m<sup>2</sup> IV once on day 1 | ||
− | |||
'''21-day cycle for up to 10 cycles''' | '''21-day cycle for up to 10 cycles''' | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # Witteveen PO, van der Velden J, Vergote I, Guerra C, Scarabeli C, Coens C, Demonty G, Reed N. Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer--Gynaecological Cancer Group). Ann Oncol. 2009 Sep;20(9):1511-6. Epub 2009 Jun 1. [https:// | + | # '''EORTC 55985:''' Witteveen PO, van der Velden J, Vergote I, Guerra C, Scarabeli C, Coens C, Demonty G, Reed N; [[Study_Groups#EORTC|EORTC]]. Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer--Gynaecological Cancer Group). Ann Oncol. 2009 Sep;20(9):1511-6. Epub 2009 Jun 1. [https://doi.org/10.1093/annonc/mdp043 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731017/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19487487/ PubMed] |
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[[Category:Vulvar cancer regimens]] | [[Category:Vulvar cancer regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:Gynecologic cancers]] | [[Category:Gynecologic cancers]] |
Latest revision as of 13:04, 30 June 2024
Section editor | |
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Alaina J. Brown, MD, MPH Vanderbilt University Nashville, TN, USA |
2 regimens on this page
2 variants on this page
|
Guidelines
Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.
NCCN
Neoadjuvant therapy
Cisplatin & RT
Cisplatin & RT: Cisplatin & Radiation Therapy
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Moore et al. 2011 | 2005-01-19 to 2009-09-21 | Phase 2 |
Chemotherapy
- Cisplatin (Platinol) 40 mg/m2 IV once per day on days 1, 8, 15, 22, 29, 36, 43
Radiotherapy
- Concurrent radiation therapy 180 cGy per day on days 1 to 5, 8 to 12, 15 to 19, 22 to 26, 29 to 33, 36 to 40, 43, 44 (32 fractions, for a dose of 5760 cGy)
6.5-week course
Subsequent treatment
- Surgical resection of residual disease (or biopsy to confirm CR)
References
- Moore DH, Ali S, Koh WJ, Michael H, Barnes MN, McCourt CK, Homesley HD, Walker JL. A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a Gynecologic Oncology Group study. Gynecol Oncol. 2012 Mar;124(3):529-33. Epub 2011 Nov 9. link to original article contains dosing details in abstract PubMed
Locally advanced or metastatic disease
Due to its relative rarity, there are very few prospective trials in advanced and metastatic vulvar cancer. In clinical practice, many adopt regimens from the cervical cancer literature; see the cervical cancer page for those regimens.
Paclitaxel monotherapy
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Witteveen et al. 2009 (EORTC 55985) | 2001-02 to 2004-12 | Phase 2 |
References
- EORTC 55985: Witteveen PO, van der Velden J, Vergote I, Guerra C, Scarabeli C, Coens C, Demonty G, Reed N; EORTC. Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer--Gynaecological Cancer Group). Ann Oncol. 2009 Sep;20(9):1511-6. Epub 2009 Jun 1. link to original article link to PMC article contains dosing details in manuscript PubMed