Interstitial brachytherapy in the treatment of advanced and recurrent vulvar cancer

OBJECTIVE: Our purpose was to evaluate the role of interstitial brachythera py in vulvar cancer management. STUDY DESIGN: From 1985-1992 we performed a retrospective study of patients treated at the University of California, Irvine Medical Center, and Long B each Memorial Medical Center. RESULTS: Eleven patients received interstitial brachytherapy, with (n = 5) or without (n = 6) external beam radiotherapy, for locally advanced (n = 5) or recurrent (n = 6) vulvar cancer. Local control was achieved in all pati ents. Ten patients have died of disease at a mean interval of 33 months fro m the time of treatment, with 9 patients having maintenance of local contro l at death. One patient is alive without disease after 77 months of follow- up. There were 2 cases of local necrosis (18%) and 1 case of rectovaginal f istula (9%). CONCLUSION: Local control of advanced vulvar cancer can be achieved with in terstitial brachytherapy, with or without external beam radiotherapy. With improved systemic therapy this treatment modality may be used to salvage wo men with bulky, symptomatic tumors.