The curative potential of radiation therapy in the treatment of primary vaginal carcinoma.

The outcome of 55 patients with primary vaginal carcinoma treated with radiation therapy at Roswell Park Cancer Institute was retrospectively reviewed. Forty-four (80%) had a squamous cell carcinoma and 11 (20%) had an adenocarcinoma. The median age was 61 years and the median dose of radiation administered, external beam and brachytherapy, was 7,040 cGy. Fifteen percent of patients developed severe radiation-induced complications, and 36% developed recurrence of disease. The overall 5-year survival and 5-year disease-free survival for the entire group was 49 and 58%, respectively. Variables positively influencing survival included younger age, early stage, involvement of the upper vagina, total radiation dosage > 7,500 cGy, and the use of combination external beam and brachytherapy. However, only age acted as an independent prognostic factor affecting survival. The pelvis was the site of disease in the majority of patients who suffered recurrence.