Carcinoma della vulva recidivo dopo chirurgia o localmente avanzato: ruolo e possibilità di chemioterapia neoadiuvante

Background: no standard treatment are avaliable for patients with locally advanced or recurrent vulvar cancer Patients and Methods:35 patients with recurrent and 26 patients with locally advanced vulvar cancer received paclitaxel/cisplatin and or without ifosfamide every 3 weeks for up to 6 cycles. Primary objective was response rate and operability rate. Secondary objective were response duration and toxicity. Response evaluation was assessed by WHO criteria; tossicity according to common toxicity criteria. Results: Sixty-one women were included with a median age of 75 (range 43-85). On study patients receveid a median of 6 cycles. Safety: grade 3 and 4 neutropenia was seen in eleven patients (11/61=18%). Efficay: overall response was 65,3%(17/26; n 17= 2 complete responses+15 partial responses)in patients with locally advanced vulvar cancer.Overall response was 40% (14/35; n 14= 2 complete responses+12 partial responses) in patients with recurrent vulvar cancer. With amedian follow-up of 24 months, median PFS was 13 months in patients with locally advanced vulvar cancer and 9 months in patients with recurrent vulvar cancer. Operability rate was 73% in patients with locally advanced vulvar cancer and 49% in patients with recurrent vulvar cancer Conclusion: this treatment allows moderate control of locally advanced and recurrent vulvar cancer with acceptable side effects