Outcomes of patients receiving radical radiation with concurrent chemotherapy for vulva cancer at Universitas Hospital Oncology Department, Free State, South Africa
Introduction and aim: Although cancer of the vulva is relatively rare in the developed world, incidence is increasing worldwide. In South Africa, increased incidence is accompanied by a decrease in age at diagnosis. Whereas patients in developed countries are often operable at presentation and undergo surgery, limited resources and the extent of presenting disease in our setting lead to an approach aiming for cure with primary radiotherapy and concurrent chemotherapy in many instances. Even with curable disease, the morbidity and mortality in these patients are high. This study aimed to measure survival outcomes in this group of patients. Methods: This is a retrospective, descriptive cohort study of vulva carcinoma patients receiving radical treatment from 2006 to 2010. We collected demographic, treatment and follow-up data, and date of death where available. Results: A total of 55 patients presented in the trial period, of which 30 met the inclusion criteria. The study population had a mean age 50 years, and 52% were HIV positive, of which 17% were on HAART. Of the HIV positive participants, most had a CD4 count above 400. Most patients had stage 3, moderately differentiated disease. The mean radiation dose received was 66.3 Gy, and nearly all patients completed concurrent chemotherapy. Adequate follow up data was only available for 7 participants, and date of death was only available for four. Survival parameters could thus not be calculated for this cohort. Conclusion: Compared to departmental numbers from 2016 and 2017, the size of our cohort was small, which gives the impression that the incidence of vulva carcinoma is increasing. We concluded that our population is not comparable to international populations, which prompts interest in finding individualized treatment. However, more studies are needed to investigate survival of these patients receiving definitive radiotherapy with concurrent chemotherapy.