Outcomes of Definitive Radiation Therapy for Primary Vaginal Carcinoma

Am J Clin Oncol. 2015 Dec;38(6):583-7. doi: 10.1097/COC.0000000000000002.


Objective(s): The aim of this study was to review treatment and outcomes of patients with primary vaginal cancer treated with definitive radiotherapy.

Materials and methods: We retrospectively reviewed medical records of 71 patients with primary vaginal adenocarcinoma or squamous cell carcinoma treated with definitive radiotherapy with at least 2 years of follow-up (median follow-up, 6.24 y).

Results: Ninety-three percent of patients were treated with external-beam radiotherapy plus brachytherapy (median dose, 7540 cGy); 4 patients with stage I disease and 1 patient with stage II disease were treated with brachytherapy alone (median dose, 6000 cGy). The cause-specific 5- and 10-year survival rates, respectively, were 96% and 96% for stage I patients, 75% and 68% for stage II patients, 69% and 64% for stage III patients, and 53% and 53% for stage IVA patients. The 5- and 10-year local-regional control rates for all patients were 79% and 75%, respectively. The 5- and 10-year distant metastasis-free survival rates for all patients were 87% and 85%, respectively. Sixteen patients had tumors involving the distal one third of the vagina. Of the 7 who received elective inguinal node irradiation, 0 failed in the inguinal nodes. Of the 9 who did not receive elective inguinal node irradiation, 2 failed in the inguinal nodes. Severe complications (grades 3 to 4) occurred in 16 patients (23%).

Conclusions: Radiotherapy provides excellent results as definitive treatment for primary vaginal cancer, although the risk of severe complications is high. Generally, treatment should consist of both external-beam radiation therapy and brachytherapy. Inguinal nodes should be irradiated electively when the primary tumor involves the distal one third of the vagina.

Publication types

  • Clinical Study

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / radiotherapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Brachytherapy / methods*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Groin
  • Humans
  • Kaplan-Meier Estimate
  • Lymph Nodes / pathology
  • Middle Aged
  • Neoplasm Staging
  • Radiotherapy / methods
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Vaginal Neoplasms / pathology
  • Vaginal Neoplasms / radiotherapy*