Vulvar cancer

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Section editor
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Alaina J. Brown, MD, MPH
Vanderbilt University
Nashville, TN, USA

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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 Evidence
Moore et al. 2011 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 Evidence
Witteveen et al. 2009 Phase 2

Chemotherapy

21-day cycle for up to 10 cycles

References

  1. 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