Difference between revisions of "Vulvar cancer"

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=Guidelines=
 
=Guidelines=
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==[https://www.nccn.org/ NCCN]==
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'''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.'''
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*[https://www.nccn.org/professionals/physician_gls/pdf/vulvar.pdf NCCN Guidelines - Vulvar Cancer]
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==NCCN==
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*[https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1476 NCCN Guidelines - Vulvar Cancer]
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**'''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]
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=Neoadjuvant therapy=
 
=Neoadjuvant therapy=
 
==Cisplatin & RT {{#subobject:89c649|Regimen=1}}==
 
==Cisplatin & RT {{#subobject:89c649|Regimen=1}}==
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<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:63d249|Variant=1}}===
 
===Regimen {{#subobject:63d249|Variant=1}}===
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{| class="wikitable" style="width: 40%; text-align:center;"  
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{| class="wikitable sortable" style="width: 60%; text-align:center;"  
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!style="width: 25%"|Study
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!style="width: 33%"|Study
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!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
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!style="width: 33%"|Dates of enrollment
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!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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|[https://doi.org/10.1016/j.ygyno.2011.11.003 Moore et al. 2011]
 
|[https://doi.org/10.1016/j.ygyno.2011.11.003 Moore et al. 2011]
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|2005-01-19 to 2009-09-21
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
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*[[Cisplatin (Platinol)]] 40 mg/m<sup>2</sup> IV once per day on days 1, 8, 15, 22, 29, 36, 43
 
*[[Cisplatin (Platinol)]] 40 mg/m<sup>2</sup> IV once per day on days 1, 8, 15, 22, 29, 36, 43
 
====Radiotherapy====
 
====Radiotherapy====
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*Concurrent [[External_beam_radiotherapy|radiation therapy]]: 1.8 Gy x 32 fractions, for a dose of 57.6 Gy
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*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'''
 
'''6.5-week course'''
 
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===References===
 
===References===
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# 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]
+
# 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]
 
=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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<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:723bf0|Variant=1}}===
 
===Regimen {{#subobject:723bf0|Variant=1}}===
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{| class="wikitable" style="width: 40%; text-align:center;"  
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{| class="wikitable sortable" style="width: 60%; text-align:center;"  
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!style="width: 25%"|Study
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!style="width: 33%"|Study
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!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
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!style="width: 33%"|Dates of enrollment
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!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
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|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731017/ Witteveen et al. 2009]
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|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731017/ Witteveen et al. 2009 (EORTC 55985)]
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|2001-02 to 2004-12
 
|style="background-color:#91cf61"|Phase 2
 
|style="background-color:#91cf61"|Phase 2
 
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</div></div>
 
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===References===
 
===References===
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# 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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# '''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]
 
[[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

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Section editor
Brown-alaina.jpeg
 Alaina J. Brown, MD, MPH
Vanderbilt University
Nashville, TN, USA
LinkedIn
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

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

References

  1. 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

Chemotherapy

21-day cycle for up to 10 cycles

References

  1. 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
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