Definitive radiation therapy for extramammary Paget's disease.

BACKGROUND

Extramammary Paget's disease (EMPD) is frequently inoperable because of old age and/or coexisting disease. We therefore reviewed the efficacy and toxicity of radiation therapy for EMPD.

PATIENTS AND METHODS

Fourteen patients with EMPD underwent definitive radiation therapy. Three patients had regional lymph node metastases before radiation therapy, but none had distant metastasis. Total doses of 52-80.2 Gy (median=60.6 Gy) were delivered to tumor sites in 26-43 fractions (median=33 fractions).

RESULTS

Four patients had developed recurrence at a median follow-up period of 47 months. The 5-year local control and disease-free rates were 71% and 63%, respectively. Two patients died of old age and renal failure at 6 and 51 months, respectively, after irradiation. The 5-year disease-free, cause-specific and overall survival rates were 46%, 100% and 79%, respectively. No therapy-related toxicities of grade 3 or greater were observed.

CONCLUSION

Radiation therapy is effective and safe, and appears to offer a curative treatment option for patients with EMPD.