Vulvar cancer
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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
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Guidelines
NCCN
Older
Neoadjuvant therapy
Cisplatin & RT
Cisplatin & RT: Cisplatin & Radiation Therapy
Regimen
Study | Evidence |
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Moore et al. 2011 | 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 1.8 Gy 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 57.6 Gy)
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 | Evidence |
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Witteveen et al. 2009 | Phase 2 |
References
- 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