Department of Gynaecology and Obstetrics, University Medical Centre of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
Department of Radiooncology and Radiotherapy, University Medical Centre of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
J Cancer Res Clin Oncol. 2023 Apr;149(4):1391-1399. doi: 10.1007/s00432-022-04006-0. Epub 2022 Apr 22.
We retrospectively investigated the widely used radiosensitisers cisplatin and mitomycin C/5-fluorouracil (5-FU) in patients with locally advanced vulvar cancer for outcome and toxicity.
We screened the archive for patients treated with chemoradiation for vulvar cancer diagnosed between 01/2010 and 08/2021 at our institution. The impact of both radiosensitisers on prognosis was compared using Kaplan-Meier method and Cox-regression analysis.
One hundred and forty-three patients with vulvar cancer were screened. Twenty-nine patients received chemoradiation (mitomycin C/5-FU n = 14; cisplatin n = 12; others n = 3) as a primary, neoadjuvant or adjuvant treatment. Median follow-up was 15.5 months. Patients in the cisplatin group were older (mean age 54.4 vs. 70.7; p = 0.004). However, the mitomycin C/5-FU group had more advanced tumour stages. The 2-year recurrence-free survival (RFS) was comparable (44.5% vs. 33.3%; p = 0.932). The 2-year overall survival (OS) showed a numerical but not statistically significant difference in favour of the mitomycin C/5-FU group (59.7% vs. 31.7%; p = 0.37). 64.3% (9 out of 14) patients, who received mitomycin C/5-FU achieved clinical complete response (cCR) compared to 41.7% (5 out of 12) who received cisplatin (p = 0.505). Radiodermatitis was the most common adverse event in both groups (81%) and more severe in the mitomycin C/5-FU cohort. Myelotoxicity was frequently observed in both groups. Eighteen patients received an additional radiation boost with 10.0 (9-16) Gy and showed a significantly prolonged RFS (p = 0.027) and OS (p = 0.003).
Mitomycin C/5-FU may be considered in the treatment of young and healthy patients with locally advanced vulvar cancer.
我们回顾性研究了广泛应用于局部晚期外阴癌的增敏剂顺铂和丝裂霉素 C/5-氟尿嘧啶（5-FU）在患者中的疗效和毒性。
我们在本院筛选了 2010 年 1 月至 2021 年 8 月期间接受放化疗治疗的外阴癌患者的档案。使用 Kaplan-Meier 方法和 Cox 回归分析比较了两种增敏剂对预后的影响。
筛选出 143 例外阴癌患者。29 例患者接受了放化疗（丝裂霉素 C/5-FU n=14；顺铂 n=12；其他 n=3）作为一线、新辅助或辅助治疗。中位随访时间为 15.5 个月。顺铂组患者年龄较大（平均年龄 54.4 岁 vs. 70.7 岁；p=0.004）。然而，丝裂霉素 C/5-FU 组的肿瘤分期更晚。2 年无复发生存率（RFS）相当（44.5% vs. 33.3%；p=0.932）。2 年总生存率（OS）虽然倾向于丝裂霉素 C/5-FU 组（59.7% vs. 31.7%；p=0.37），但差异无统计学意义。接受丝裂霉素 C/5-FU 治疗的患者中，9 例（9/14）达到临床完全缓解（cCR），而接受顺铂治疗的患者中，5 例（5/12）达到 cCR（p=0.505）。两组中最常见的不良反应均为放射性皮炎（81%），丝裂霉素 C/5-FU 组更严重。两组均常发生骨髓抑制。18 例患者接受了 10.0（9-16）Gy 的额外放疗增敏，RFS（p=0.027）和 OS（p=0.003）显著延长。
对于局部晚期外阴癌的年轻健康患者，可考虑使用丝裂霉素 C/5-FU 治疗。
