Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Roma, Italy.
Radiation Oncology Unit, Gemelli Molise Hospital, Università Cattolica del Sacro Cuore, Campobasso, Italy.
Clin Transl Oncol. 2021 Aug;23(8):1611-1619. doi: 10.1007/s12094-021-02557-1. Epub 2021 Mar 1.
The aim of our systematic review was to assess the role of interventional radiotherapy (IRT, brachytherapy) in the management of primary and/or recurrent vulvar carcinoma.
A systematic research using PubMed, Scopus and Cochrane library was performed. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. Only full-text English-language articles related to IRT for treatment of primary or recurrent VC were identified and reviewed. Conference paper, survey, letter, editorial, book chapter and review were excluded. Time restriction (1990-2018) as concerns the years of the publication was considered.
Primary disease: the median 5-year LC was 43.5% (range 19-68%); the median 5-year DFS was 44.5% (range 44-81%); the median 5-year OS was 50.5% (range 27-85%). Recurrent disease: the median 5-year DFS was 64% (range 56-72%) and the median 5-year OS was 45% (range 33%-57%). Acute ≥ grade 2 toxicity was reported in three patients (1.6%). The severe late toxicity rates (grade 3-4) ranged from 0% to 14.3% (median 7.7%).
IRT as part of primary treatment for primary and/or recurrent vulvar cancer is associated with promising clinical outcomes.
本系统评价的目的是评估介入放射治疗（IRT，近距离放疗）在原发性和/或复发性外阴癌治疗中的作用。
使用 PubMed、Scopus 和 Cochrane 图书馆进行了系统研究。在 ClinicalTrials.gov 上搜索正在进行或最近完成的试验，并在 PROSPERO 上搜索正在进行或最近完成的系统评价。仅确定并审查了与 IRT 治疗原发性或复发性 VC 相关的全文英文文章。排除会议论文、调查、信件、社论、书籍章节和评论。考虑到出版年份的时间限制（1990-2018 年）。
原发性疾病：中位 5 年无复发生存率（LC）为 43.5%（范围 19-68%）；中位 5 年无病生存率（DFS）为 44.5%（范围 44-81%）；中位 5 年总生存率（OS）为 50.5%（范围 27-85%）。复发性疾病：中位 5 年 DFS 为 64%（范围 56-72%），中位 5 年 OS 为 45%（范围 33%-57%）。有 3 名患者（1.6%）报告出现急性≥2 级毒性。严重晚期毒性（3-4 级）发生率为 0%-14.3%（中位数为 7.7%）。
IRT 作为原发性和/或复发性外阴癌治疗的一部分，与有前景的临床结果相关。
