Advertisement

Carcinoma of the Vagina

  • Higinia R. Cardenes
  • Jennifer E. Zook
  • David L. Andolino
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Primary vaginal cancer is a rare entity representing about 2% of all female genital neoplasias and only 0.1–0.2% of all cancers (Jemal et al. 59(4):225–249, 2009). Most carcinomas found in the vagina represent direct extension or metastasis from other primary gynecologic (cervix or vulva) and non-gynecologic sites, most commonly breast and gastrointestinal tract. There are a number of controversies in terms of epidemiology, staging, and diagnostic evaluation as well as in the management of vaginal cancer. Because of its rarity, there is a lack of prospective, randomized studies in patients with vaginal cancer, and therefore it is difficult to establish strong, evidence based-recommendations. Decisions regarding therapeutic options are for the most part, based on retrospective data and individual assessment using general principles derived from clinical experience in the cancer management in other sites. Most of the available data refer to the treatment of primary invasive SCC of the vagina, since this represents the most common histology.

Keywords

Intensity Modulate Radiation Therapy Stereotactic Body Radiotherapy Figo Stage High Dose Rate National Cancer Data Base 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Aho M, Vesterinen E, Meyer B, Purola E, Paavonen J (1991) Natural history of vaginal intraepithelial neoplasia. Cancer 68(1):195–197PubMedCrossRefGoogle Scholar
  2. Aktas M, de Jong D, Nuyttens JJ, van der Zee J, Wielheesen DH, Batman E, Burger CW, Ansink AC (2007) Concomitant radiotherapy and hyperthermia for primary carcinoma of the vagina: a cohort study. Eur J Obstet Gynecol Reprod Biol 133(1):100–104. doi: 10.1016/j.ejogrb.2006.05.005 Google Scholar
  3. Ali MM, Huang DT, Goplerud DR, Howells R, Lu JD (1996) Radiation alone for carcinoma of the vagina: variation in response related to the location of the primary tumor. Cancer 77(9):1934–1939. doi: 10.1002/(SICI)1097-0142(19960501)77:9<1934::AID-CNCR25>3.0.CO;2 Google Scholar
  4. Al-Kurdi M, Monaghan JM (1981) Thirty-two years experience in management of primary tumours of the vagina. Br J Obstet Gynaecol 88(11):1145–1150PubMedCrossRefGoogle Scholar
  5. American Joint Committee on Cancer (2010) Vagina. In: Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti III A (eds) AJCC Cancer Staging Manual, 7th edn. Springer, New York, pp 469–472Google Scholar
  6. Antonioli DA, Burke L (1975) Vaginal adenosis. Analysis of 325 biopsy specimens from 100 patients. Am J Clin Pathol 64(5):625–638PubMedGoogle Scholar
  7. Au SP, Grigsby PW (2003) The irradiation tolerance dose of the proximal vagina. Radiother Oncol 67(1):77–85. S0167814002003845[pii]PubMedCrossRefGoogle Scholar
  8. Ball HG, Berman ML (1982) Management of primary vaginal carcinoma. Gynecol Oncol 14(2):154–163. 0090-8258(82)90085-3[pii]PubMedCrossRefGoogle Scholar
  9. Benedetti Panici P, Bellati F, Plotti F, Di Donato V, Antonilli M, Perniola G, Manci N, Muzii L, Angioli R (2008) Neoadjuvant chemotherapy followed by radical surgery in patients affected by vaginal carcinoma. Gynecol Oncol 111(2):307–311. doi:  10.1016/j.ygyno.2008.07.005 PubMedCrossRefGoogle Scholar
  10. Beriwal S, Bhatnagar A, Heron DE, Selvaraj R, Mogus R, Kim H, Gerszten K, Kelley J, Edwards RP (2006) High-dose-rate interstitial brachytherapy for gynecologic malignancies. Brachytherapy 5(4):218–222. doi: 10.1016/j.brachy.2006.09.002 Google Scholar
  11. Beriwal S, Heron DE, Mogus R, Edwards RP, Kelley JL, Sukumvanich P (2008) High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina. Radiat Oncol 3:7. doi: 10.1186/1748-717X-3-7
  12. Boonlikit S, Noinual N (2010) Vaginal intraepithelial neoplasia: a retrospective analysis of clinical features and colpohistology. J Obstet Gynaecol Res 36(1):94–100. doi: 10.1111/j.1447-0756.2009.01108.x Google Scholar
  13. Brabham JG, Cardenes HR (2009) Permanent interstitial reirradiation with 198Au as salvage therapy for low volume recurrent gynecologic malignancies: a single institution experience. Am J Clin Oncol 32(4):417–422. doi: 10.1097/COC.0b013e318191bfc7 PubMedCrossRefGoogle Scholar
  14. Brinton LA, Nasca PC, Mallin K, Schairer C, Rosenthal J, Rothenberg R, Yordan E Jr, Richart RM (1990) Case-control study of in situ and invasive carcinoma of the vagina. Gynecol Oncol 38(1):49–54. 0090-8258(90)90010-I[pii]PubMedCrossRefGoogle Scholar
  15. Cardenes H, Song G, Randall M (2001) Late sequelae of radiation therapy in the management of gynecological malignancies. Current medical literature. Gynecol Oncol 2:1–10Google Scholar
  16. Chang YC, Hricak H, Thurnher S, Lacey CG (1988) Vagina: evaluation with MR imaging. Part II. Neoplasms. Radiology 169(1):175–179PubMedGoogle Scholar
  17. Charra C, Roy P, Coquard R, Romestaing P, Ardiet JM, Gerard JP (1998) Outcome of treatment of upper third vaginal recurrences of cervical and endometrial carcinomas with interstitial brachytherapy. Int J Radiat Oncol Biol Phys 40(2):421–426. S0360301697005762[pii]PubMedCrossRefGoogle Scholar
  18. Childers JM, Surwit EA (1993) Current status of operative laparoscopy in gynecologic oncology. Oncology (Williston Park) 7(11):47–51 discussion 53-44, 57Google Scholar
  19. Chu AM, Beechinor R (1984) Survival and recurrence patterns in the radiation treatment of carcinoma of the vagina. Gynecol Oncol 19(3):298–307PubMedCrossRefGoogle Scholar
  20. Chyle V, Zagars GK, Wheeler JA, Wharton JT, Delclos L (1996) Definitive radiotherapy for carcinoma of the vagina: outcome and prognostic factors. Int J Radiat Oncol Biol Phys 35(5):891–905. doi: 10.1016/0360-3016(95)02394-1 PubMedCrossRefGoogle Scholar
  21. Corn BW, Lanciano RM, Rosenblum N, Schnall M, King S, Epperson R (1995) Improved treatment planning for the Syed-Neblett template using endorectal-coil magnetic resonance and intraoperative (laparotomy/laparoscopy) guidance: a new integrated technique for hysterectomized women with vaginal tumors. Gynecol Oncol 56(2):255–261. doi: 10.1006/gyno.1995.1042
  22. Creasman WT, Phillips JL, Menck HR (1998) The National Cancer Data Base report on cancer of the vagina. Cancer 83(5):1033–1040. doi: 10.1002/(SICI)1097-0142(19980901)83:5<1033::AID-CNCR30>3.0.CO;2-6
  23. Daling JR, Madeleine MM, Schwartz SM, Shera KA, Carter JJ, McKnight B, Porter PL, Galloway DA, McDougall JK, Tamimi H (2002) A population-based study of squamous cell vaginal cancer: HPV and cofactors. Gynecol Oncol 84(2):263–270. doi: 10.1006/gyno.2001.6502 Google Scholar
  24. Dalrymple JL, Russell AH, Lee SW, Scudder SA, Leiserowitz GS, Kinney WK, Smith LH (2004) Chemoradiation for primary invasive squamous carcinoma of the vagina. Int J Gynecol Cancer 14(1):110–117. 14066[pii]PubMedCrossRefGoogle Scholar
  25. Dancuart F, Delclos L, Wharton JT, Silva EG (1988) Primary squamous cell carcinoma of the vagina treated by radiotherapy: a failures analysis–the M. D. Anderson Hospital experience 1955–1982. Int J Radiat Oncol Biol Phys 14(4):745–749PubMedCrossRefGoogle Scholar
  26. Davis KP, Stanhope CR, Garton GR, Atkinson EJ, O’Brien PC (1991) Invasive vaginal carcinoma: analysis of early-stage disease. Gynecol Oncol 42(2):131–136PubMedCrossRefGoogle Scholar
  27. de Crevoisier R, Sanfilippo N, Gerbaulet A, Morice P, Pomel C, Castaigne D, Pautier P, Lhomme C, Duvillard P, Haie-meder C (2007) Exclusive radiotherapy for primary squamous cell carcinoma of the vagina. Radiother Oncol 85(3):362–370. doi: 10.1016/j.radonc.2007.09.015 Google Scholar
  28. Delanian S, Porcher R, Balla-Mekias S, Lefaix JL (2003) Randomized, placebo-controlled trial of combined pentoxifylline and tocopherol for regression of superficial radiation-induced fibrosis. J Clin Oncol 21(13):2545–2550. doi: 10.1200/JCO.2003.06.064 Google Scholar
  29. Delclos L (1984) Technical basis of radiation therapy practical clinical applications. Lea & Febiger, PhiladelphiaGoogle Scholar
  30. Delclos L, Fletcher GH, Moore EB, Sampiere VA (1980) Minicolpostats, dome cylinders, other additions and improvements of the Fletcher-suit afterloadable system: indications and limitations of their use. Int J Radiat Oncol Biol Phys 6(9):1195–1206PubMedCrossRefGoogle Scholar
  31. Deodato F, Macchia G, Grimaldi L, Ferrandina G, Lorusso D, Salutari V, Cilla S, Valentini V, Cellini N, Piermattei A, Scambia G, Morganti AG (2009) Stereotactic radiotherapy in recurrent gynecological cancer: a case series. Oncol Rep 22(2):415–419PubMedGoogle Scholar
  32. Diakomanolis E, Rodolakis A, Boulgaris Z, Blachos G, Michalas S (2002) Treatment of vaginal intraepithelial neoplasia with laser ablation and upper vaginectomy. Gynecol Obstet Invest 54(1):17–20. goi54017[pii]PubMedCrossRefGoogle Scholar
  33. Disaia PJ, Syed N, Puthawala AA (1990) Malignant neoplasia of the upper vagina. Endocurietherapy/Hyperthermia Oncol 6:251–256Google Scholar
  34. Dittmer PH, Randall ME (2001) A technique for inguinal node boost using photon fields defined by asymmetric collimator jaws. Radiother Oncol 59(1):61–64. S0167814000002279[pii]PubMedCrossRefGoogle Scholar
  35. Dixit S, Singhal S, Baboo HA (1993) Squamous cell carcinoma of the vagina: a review of 70 cases. Gynecol Oncol 48(1):80–87. doi: 10.1006/gyno.1993.1013 Google Scholar
  36. Ebrahim S, Daponte A, Smith TH, Tiltman A, Guidozzi F (2001) Primary mucinous adenocarcinoma of the vagina. Gynecol Oncol 80(1):89–92. doi: 10.1006/gyno.2000.5963 Google Scholar
  37. Eddy GL, Marks RD Jr, Miller MC 3rd, Underwood PB Jr (1991) Primary invasive vaginal carcinoma. Am J Obstet Gynecol 165(2):292–296. 0002-9378(91)90081-2[pii] discussion 296–298PubMedGoogle Scholar
  38. Epstein JA, Sung R, Wang JC (2001) Re: correlation between a positive Hoffmann’s reflex and cervical pathology in asymptomatic individuals. Spine (Phila Pa 1976) 26(14):1639–1640CrossRefGoogle Scholar
  39. Evans LS, Kersh CR, Constable WC, Taylor PT (1988) Concomitant 5-fluorouracil, mitomycin-C, and radiotherapy for advanced gynecologic malignancies. Int J Radiat Oncol Biol Phys 15(4):901–906PubMedCrossRefGoogle Scholar
  40. Fanning J, Manahan KJ, McLean SA (1999) Loop electrosurgical excision procedure for partial upper vaginectomy. Am J Obstet Gynecol 181(6):1382–1385. S0002937899007425[pii]PubMedCrossRefGoogle Scholar
  41. FIGO Committee on Gynecologic Oncology (2009) Current FIGO staging for cancer of the vagina, fallopian tube, ovary, and gestational trophoblastic neoplasia. Int J Gynecol Obstet 105(1):3–4CrossRefGoogle Scholar
  42. Franckena M, Stalpers LJ, Koper PC, Wiggenraad RG, Hoogenraad WJ, van Dijk JD, Warlam-Rodenhuis CC, Jobsen JJ, van Rhoon GC, van der Zee J (2008) Long-term improvement in treatment outcome after radiotherapy and hyperthermia in locoregionally advanced cervix cancer: an update of the Dutch Deep Hyperthermia Trial. Int J Radiat Oncol Biol Phys 70(4):1176–1182. doi: 10.1016/j.ijrobp.2007.07.2348 Google Scholar
  43. Frank SJ, Jhingran A, Levenback C, Eifel PJ (2005) Definitive radiation therapy for squamous cell carcinoma of the vagina. Int J Radiat Oncol Biol Phys 62(1):138–147. doi: 10.1016/j.ijrobp.2004.09.032 Google Scholar
  44. Frank SJ, Deavers MT, Jhingran A, Bodurka DC, Eifel PJ (2007) Primary adenocarcinoma of the vagina not associated with diethylstilbestrol (DES) exposure. Gynecol Oncol 105(2):470–474. doi: 10.1016/j.ygyno.2007.01.005 Google Scholar
  45. Frumovitz M, Gayed IW, Jhingran A, Euscher ED, Coleman RL, Ramirez PT, Levenback CF (2008) Lymphatic mapping and sentinel lymph node detection in women with vaginal cancer. Gynecol Oncol 108(3):478–481. doi: 10.1016/j.ygyno.2007.12.001 Google Scholar
  46. Gallup DG, Castle CA, Stock RJ (1987a) Recurrent carcinoma in situ of the vagina following split-thickness skin graft vaginoplasty. Gynecol Oncol 26(1):98–102PubMedCrossRefGoogle Scholar
  47. Gallup DG, Talledo OE, Shah KJ, Hayes C (1987b) Invasive squamous cell carcinoma of the vagina: a 14-year study. Obstet Gynecol 69(5):782–785PubMedGoogle Scholar
  48. Garton GR, Gunderson LL, Webb MJ, Wilson TO, Cha SS, Podratz KC (1997) Intraoperative radiation therapy in gynecologic cancer: update of the experience at a single institution. Int J Radiat Oncol Biol Phys 37(4):839–843. S0360-3016(96)00546-9[pii]PubMedCrossRefGoogle Scholar
  49. Gemignani ML, Alektiar KM, Leitao M, Mychalczak B, Chi D, Venkatraman E, Barakat RR, Curtin JP (2001) Radical surgical resection and high-dose intraoperative radiation therapy (HDR-IORT) in patients with recurrent gynecologic cancers. Int J Radiat Oncol Biol Phys 50(3):687–694. S0360-3016(01)01507-3[pii]PubMedCrossRefGoogle Scholar
  50. Gore E, Gillin MT, Albano K, Erickson B (1995) Comparison of high dose-rate and low dose-rate dose distributions for vaginal cylinders. Int J Radiat Oncol Biol Phys 31(1):165–170. 036030169400326G[pii]PubMedCrossRefGoogle Scholar
  51. Grigsby PW, Russell A, Bruner D, Eifel P, Koh WJ, Spanos W, Stetz J, Stitt JA, Sullivan J (1995) Late injury of cancer therapy on the female reproductive tract. Int J Radiat Oncol Biol Phys 31(5):1281–1299. 036030169400426L[pii]PubMedCrossRefGoogle Scholar
  52. Guckenberger M, Bachmann J, Wulf J, Mueller G, Krieger T, Baier K, Richter A, Wilbert J, Flentje M (2010) Stereotactic body radiotherapy for local boost irradiation in unfavourable locally recurrent gynaecological cancer. Radiother Oncol 94(1):53–59. doi: 10.1016/j.radonc.2009.12.004 Google Scholar
  53. Gupta AK, Vicini FA, Frazier AJ, Barth-Jones DC, Edmundson GK, Mele E, Gustafson GS, Martinez AA (1999) Iridium-192 transperineal interstitial brachytherapy for locally advanced or recurrent gynecological malignancies. Int J Radiat Oncol Biol Phys 43(5):1055–1060. S0360-3016(98)00522-7[pii]PubMedCrossRefGoogle Scholar
  54. Haddock MG, Martinez-Monge R, Petersen IA, Wilson TO (1999) Locally advanced primary and recurrent gynecologic malignancies. EBRT with or without IORT or HDR-IORT. In: Gunderson LL, Willet CG BHL, Calvo FA (eds) Intraoperative Irradiation: Techniques and Results. Current Clinical Oncology. Humana Press, New Totowa, pp 397–419Google Scholar
  55. Haskel S, Chen SS, Spiegel G (1989) Vaginal endometrioid adenocarcinoma arising in vaginal endometriosis: a case report and literature review. Gynecol Oncol 34(2):232–236. 0090-8258(89)90149-2[pii]PubMedCrossRefGoogle Scholar
  56. Hellman K, Lundell M, Silfversward C, Nilsson B, Hellstrom AC, Frankendal B (2006) Clinical and histopathologic factors related to prognosis in primary squamous cell carcinoma of the vagina. Int J Gynecol Cancer 16(3):1201–1211. doi: 10.1111/j.1525-1438.2006.00520.x Google Scholar
  57. Herbst AL, Robboy SJ, Scully RE, Poskanzer DC (1974) Clear-cell adenocarcinoma of the vagina and cervix in girls: analysis of 170 registry cases. Am J Obstet Gynecol 119(5):713–724PubMedGoogle Scholar
  58. Hilaris BS, Nori D, Anderson LL (1987) Brachytherapy treatment planning. Front Radiat Ther Oncol 21:94–106PubMedGoogle Scholar
  59. Hinchey WW, Silva EG, Guarda LA, Ordonez NG, Wharton JT (1983) Paravaginal wolffian duct (mesonephros) adenocarcinoma: a light and electron microscopic study. Am J Clin Pathol 80(4):539–544PubMedGoogle Scholar
  60. Hintz BL, Kagan AR, Chan P, Gilbert HA, Nussbaum H, Rao AR, Wollin M (1980) Radiation tolerance of the vaginal mucosa. Int J Radiat Oncol Biol Phys 6(6):711–716. 0360-3016(80)90227-8[pii]PubMedCrossRefGoogle Scholar
  61. Hiroi H, Yasugi T, Matsumoto K, Fujii T, Watanabe T, Yoshikawa H, Taketani Y (2001) Mucinous adenocarcinoma arising in a neovagina using the sigmoid colon thirty years after operation: a case report. J Surg Oncol 77(1):61–64. doi: 10.1002/jso.1067 PubMedCrossRefGoogle Scholar
  62. Hoffman MS, Roberts WS, LaPolla JP, Fiorica JV, Cavanagh D (1991) Laser vaporization of grade 3 vaginal intraepithelial neoplasia. Am J Obstet Gynecol 165(5 Pt 1):1342–1344PubMedGoogle Scholar
  63. Hoffman MS, DeCesare SL, Roberts WS, Fiorica JV, Finan MA, Cavanagh D (1992) Upper vaginectomy for in situ and occult, superficially invasive carcinoma of the vagina. Am J Obstet Gynecol 166(1 Pt 1):30–33PubMedGoogle Scholar
  64. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009) Cancer statistics, 2009. CA Cancer J Clin 59(4):225–249. doi: 10.3322/caac.20006
  65. Jobson VW, Homesley HD (1983) Treatment of vaginal intraepithelial neoplasia with the carbon dioxide laser. Obstet Gynecol 62(1):90–93PubMedGoogle Scholar
  66. Julian TM, O’Connell BJ, Gosewehr JA (1992) Indications, techniques, and advantages of partial laser vaginectomy. Obstet Gynecol 80(1):140–143PubMedGoogle Scholar
  67. Kaufman RH, Korhonen MO, Strama T, Adam E, Kaplan A (1982) Development of clear cell adenocarcinoma in DES-exposed offspring under observation. Obstet Gynecol 59(6 Suppl):68S–72SPubMedGoogle Scholar
  68. Keys HM, Bundy BN, Stehman FB, Muderspach LI, Chafe WE, Suggs CL 3rd, Walker JL, Gersell D (1999) Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med 340(15):1154–1161PubMedCrossRefGoogle Scholar
  69. Kirkbride P, Fyles A, Rawlings GA, Manchul L, Levin W, Murphy KJ, Simm J (1995) Carcinoma of the vagina–experience at the Princess Margaret Hospital (1974–1989). Gynecol Oncol 56(3):435–443. doi: 10.1006/gyno.1995.1077 Google Scholar
  70. Krebs HB (1989) Treatment of vaginal intraepithelial neoplasia with laser and topical 5-fluorouracil. Obstet Gynecol 73(4):657–660PubMedGoogle Scholar
  71. Kucera H, Vavra N (1991) Radiation management of primary carcinoma of the vagina: clinical and histopathological variables associated with survival. Gynecol Oncol 40(1):12–16PubMedCrossRefGoogle Scholar
  72. Kucera H, Mock U, Knocke TH, Kucera E, Potter R (2001) Radiotherapy alone for invasive vaginal cancer: outcome with intracavitary high dose rate brachytherapy versus conventional low dose rate brachytherapy. Acta Obstet Gynecol Scand 80(4):355–360. aog800412[pii]PubMedGoogle Scholar
  73. Kushner DM, Fleming PA, Kennedy AW, Wilkinson DA, Lee E, Saffle PA (2003) High dose rate (192)Ir afterloading brachytherapy for cancer of the vagina. Br J Radiol 76(910):719–725PubMedCrossRefGoogle Scholar
  74. Lamoreaux WT, Grigsby PW, Dehdashti F, Zoberi I, Powell MA, Gibb RK, Rader JS, Mutch DG, Siegel BA (2005) FDG-PET evaluation of vaginal carcinoma. Int J Radiat Oncol Biol Phys 62(3):733–737. doi: 10.1016/j.ijrobp.2004.12.011 Google Scholar
  75. Lee WR, Marcus RB Jr, Sombeck MD, Mendenhall WM, Morgan LS, Freeman DE, Million RR (1994) Radiotherapy alone for carcinoma of the vagina: the importance of overall treatment time. Int J Radiat Oncol Biol Phys 29(5):983–988PubMedCrossRefGoogle Scholar
  76. Lenehan PM, Meffe F, Lickrish GM (1986) Vaginal intraepithelial neoplasia: biologic aspects and management. Obstet Gynecol 68(3):333–337PubMedGoogle Scholar
  77. Leung S, Sexton M (1993) Radical radiation therapy for carcinoma of the vagina–impact of treatment modalities on outcome: Peter MacCallum Cancer Institute experience 1970–1990. Int J Radiat Oncol Biol Phys 25(3):413–418PubMedCrossRefGoogle Scholar
  78. Li Z, Liu C, Palta JR (1998) Optimized dose distribution of a high dose rate vaginal cylinder. Int J Radiat Oncol Biol Phys 41(1):239–244. S0360-3016(98)00014-5[pii]PubMedCrossRefGoogle Scholar
  79. Lian J, Dundas G, Carlone M, Ghosh S, Pearcey R (2008) Twenty-year review of radiotherapy for vaginal cancer: an institutional experience. Gynecol Oncol 111(2):298–306. doi: 10.1016/j.ygyno.2008.07.007 Google Scholar
  80. Maassen V, Lampe B, Untch M, Mikorey S, Hepp H, Kindermann G (1993) Adenocarcinoma and adenosis of the vagina. On the histogenesis, diagnosis and therapy of a rare genital neoplasms. Geburtshilfe Frauenheilkd 53(5):308–313. doi: 10.1055/s-2007-1022888 PubMedCrossRefGoogle Scholar
  81. MacLeod C, Fowler A, Dalrymple C, Atkinson K, Elliott P, Carter J (1997) High-dose-rate brachytherapy in the management of high-grade intraepithelial neoplasia of the vagina. Gynecol Oncol 65(1):74–77. doi: 10.1006/gyno.1996.4608 Google Scholar
  82. MacNaught R, Symonds RP, Hole D, Watson ER (1986) Improved control of primary vaginal tumours by combined external-beam and interstitial radiotherapy. Clin Radiol 37(1):29–32. S0009-9260(86)80160-X[pii]PubMedCrossRefGoogle Scholar
  83. Magrina JF, Masterson BJ (1981) Vaginal reconstruction in gynecological oncology: a review of techniques. Obstet Gynecol Surv 36(1):1–10PubMedCrossRefGoogle Scholar
  84. Martinez A, Cox RS, Edmundson GK (1984) A multiple-site perineal applicator (MUPIT) for treatment of prostatic, anorectal, and gynecologic malignancies. Int J Radiat Oncol Biol Phys 10(2):297–305. 0360-3016(84)90016-6[pii]PubMedCrossRefGoogle Scholar
  85. Menkarios C, Azria D, Laliberte B, Moscardo CL, Gourgou S, Lemanski C, Dubois JB, Ailleres N, Fenoglietto P (2007) Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans. Radiat Oncol 2:41. doi: 10.1186/1748-717X-2-41
  86. Milano MT, Jani AB, Farrey KJ, Rash C, Heimann R, Chmura SJ (2005) Intensity-modulated radiation therapy (IMRT) in the treatment of anal cancer: toxicity and clinical outcome. Int J Radiat Oncol Biol Phys 63(2):354–361. doi: 10.1016/j.ijrobp.2005.02.030 Google Scholar
  87. Mock U, Kucera H, Fellner C, Knocke TH, Potter R (2003) High-dose-rate (HDR) brachytherapy with or without external beam radiotherapy in the treatment of primary vaginal carcinoma: long-term results and side effects. Int J Radiat Oncol Biol Phys 56(4):950–957. S0360301603002177[pii]PubMedCrossRefGoogle Scholar
  88. Molla M, Escude L, Nouet P, Popowski Y, Hidalgo A, Rouzaud M, Linero D, Miralbell R (2005) Fractionated stereotactic radiotherapy boost for gynecologic tumors: an alternative to brachytherapy? Int J Radiat Oncol Biol Phys 62(1):118–124. doi: 10.1016/j.ijrobp.2004.09.028 Google Scholar
  89. Moore DH, Thomas GM, Montana GS, Saxer A, Gallup DG, Olt G (1998) Preoperative chemoradiation for advanced vulvar cancer: a phase II study of the Gynecologic Oncology Group. Int J Radiat Oncol Biol Phys 42(1):79–85. S0360-3016(98)00193-X[pii]PubMedCrossRefGoogle Scholar
  90. Moran MS, Castrucci WA, Ahmad M, Song H, Lund MW, Mani S, Chamberlain D, Higgins SA (2010) Clinical utility of the modified segmental boost technique for treatment of the pelvis and inguinal nodes. Int J Radiat Oncol Biol Phys 76(4):1026–1036. doi: 10.1016/j.ijrobp.2009.02.066 Google Scholar
  91. Morris M, Eifel PJ, Lu J, Grigsby PW, Levenback C, Stevens RE, Rotman M, Gershenson DM, Mutch DG (1999) Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med 340(15):1137–1143PubMedCrossRefGoogle Scholar
  92. Munkarah A, Malone JM Jr, Budev HD, Evans TN (1994) Mucinous adenocarcinoma arising in a neovagina. Gynecol Oncol 52(2):272–275. doi: 10.1006/gyno.1994.1045 Google Scholar
  93. Nanavati PJ, Fanning J, Hilgers RD, Hallstrom J, Crawford D (1993) High-dose-rate brachytherapy in primary stage I and II vaginal cancer. Gynecol Oncol 51(1):67–71. doi: 10.1006/gyno.1993.1248 Google Scholar
  94. Ogino I, Kitamura T, Okajima H, Matsubara S (1998) High-dose-rate intracavitary brachytherapy in the management of cervical and vaginal intraepithelial neoplasia. Int J Radiat Oncol Biol Phys 40(4):881–887. S0360-3016(97)00924-3[pii]PubMedCrossRefGoogle Scholar
  95. Otton GR, Nicklin JL, Dickie GJ, Niedetzky P, Tripcony L, Perrin LC, Crandon AJ (2004) Early-stage vaginal carcinoma–an analysis of 70 patients. Int J Gynecol Cancer 14(2):304–310. doi: 10.1111/j.1048-891X.2004.014214.x Google Scholar
  96. Parikh JH, Barton DP, Ind TE, Sohaib SA (2008) MR imaging features of vaginal malignancies. Radiographics 28(1):49–63; quiz 322. doi: 10.1148/rg.281075065 Google Scholar
  97. Pepek JM, Willett CG, Wu QJ, Yoo S, Clough RW, Czito BG (2010) intensity-modulated radiation therapy for anal malignancies: a preliminary toxicity and disease outcomes analysis. Int J Radiat Oncol Biol Phys. doi: 10.1016/j.ijrobp.2009.09.046
  98. Perez CA, Arneson AN, Galakatos A, Samanth HK (1973) Malignant tumors of the vagina. Cancer 31(1):36–44PubMedCrossRefGoogle Scholar
  99. Perez CA, Korba A, Sharma S (1977) Dosimetric considerations in irradiation of carcinoma of the vagina. Int J Radiat Oncol Biol Phys 2(7–8):639–649PubMedCrossRefGoogle Scholar
  100. Perez CA, Camel HM, Galakatos AE, Grigsby PW, Kuske RR, Buchsbaum G, Hederman MA (1988) Definitive irradiation in carcinoma of the vagina: long-term evaluation of results. Int J Radiat Oncol Biol Phys 15(6):1283–1290PubMedCrossRefGoogle Scholar
  101. Perez CA, Slessinger E, Grigsby PW (1990) Design of an afterloading vaginal applicator (MIRALVA). Int J Radiat Oncol Biol Phys 18(6):1503–1508PubMedCrossRefGoogle Scholar
  102. Perez CA, Grigsby PW, Garipagaoglu M, Mutch DG, Lockett MA (1999) Factors affecting long-term outcome of irradiation in carcinoma of the vagina. Int J Radiat Oncol Biol Phys 44(1):37–45. S0360-3016(98)00530-6[pii]PubMedCrossRefGoogle Scholar
  103. Peters WA 3rd, Kumar NB, Morley GW (1985) Carcinoma of the vagina. Factors influencing treatment outcome. Cancer 55(4):892–897PubMedCrossRefGoogle Scholar
  104. Petrilli ES, Townsend DE, Morrow CP, Nakao CY (1980) Vaginal intraepithelial neoplasia: biologic aspects and treatment with topical 5-fluorouracil and the carbon dioxide laser. Am J Obstet Gynecol 138(3):321–328PubMedGoogle Scholar
  105. Pingley S, Shrivastava SK, Sarin R, Agarwal JP, Laskar S, Deshpande DD, Dinshaw KA (2000) Primary carcinoma of the vagina: Tata Memorial Hospital experience. Int J Radiat Oncol Biol Phys 46(1):101–108. S0360-3016(99)00360-0[pii]PubMedCrossRefGoogle Scholar
  106. Piver MS, Barlow JJ, Tsukada Y, Gamarra M, Sandecki A (1979) Postirradiation squamous cell carcinoma in situ of the vagina: treatment by topical 20 percent 5-fluorouracil cream. Am J Obstet Gynecol 135(3):377–380. 0002-9378(79)90709-9[pii]PubMedGoogle Scholar
  107. Plentl AA, Friedman EA (1971) Lymphatic system of the female genitalia. The morphologic basis of oncologic diagnosis and therapy. Major Probl Obstet Gynecol 2:1–223PubMedGoogle Scholar
  108. Prempree T, Amornmarn R (1985) Radiation treatment of primary carcinoma of the vagina. Patterns of failures after definitive therapy. Acta Radiol Oncol 24(1):51–56PubMedCrossRefGoogle Scholar
  109. Puthawala A, Syed AM, Nalick R, McNamara C, DiSaia PJ (1983) Integrated external and interstitial radiation therapy for primary carcinoma of the vagina. Obstet Gynecol 62(3):367–372PubMedCrossRefGoogle Scholar
  110. Randall ME, Evans L, Greven KM, McCunniff AJ, Doline RM (1993) Interstitial reirradiation for recurrent gynecologic malignancies: results and analysis of prognostic factors. Gynecol Oncol 48(1):23–31. doi: 10.1006/gyno.1993.1005 Google Scholar
  111. Reddy S, Saxena VS, Lee MS, Yordan EL, Graham JE, Phillips R, Hendrickson FR (1991) Results of radiotherapeutic management of primary carcinoma of the vagina. Int J Radiat Oncol Biol Phys 21(4):1041–1044. 0360-3016(91)90747-R[pii]PubMedCrossRefGoogle Scholar
  112. Reid GC, Schmidt RW, Roberts JA, Hopkins MP, Barrett RJ, Morley GW (1989) Primary melanoma of the vagina: a clinicopathologic analysis. Obstet Gynecol 74(2):190–199. 0029-7844(89)90057-4[pii]PubMedGoogle Scholar
  113. Riva C, Fabbri A, Facco C, Tibiletti MG, Guglielmin P, Capella C (1997) Primary serous papillary adenocarcinoma of the vagina: a case report. Int J Gynecol Pathol 16(3):286–290PubMedCrossRefGoogle Scholar
  114. Robboy SJ, Herbst AL, Scully RE (1974) Clear-cell adenocarcinoma of the vagina and cervix in young females: analysis of 37 tumors that persisted or recurred after primary therapy. Cancer 34(3):606–614PubMedCrossRefGoogle Scholar
  115. Robboy SJ, Scully RE, Welch WR, Herbst AL (1977) Intrauterine diethylstilbestrol exposure and its consequences: pathologic characteristics of vaginal adenosis, clear cell adenocarcinoma, and related lesions. Arch Pathol Lab Med 101(1):1–5PubMedGoogle Scholar
  116. Robboy SJ, Welch WR, Young RH, Truslow GY, Herbst AL, Scully RE (1982) Topographic relation of cervical ectropion and vaginal adenosis to clear cell adenocarcinoma. Obstet Gynecol 60(5):546–551PubMedGoogle Scholar
  117. Robboy SJ, Young RH, Welch WR, Truslow GY, Prat J, Herbst AL, Scully RE (1984) Atypical vaginal adenosis and cervical ectropion. Association with clear cell adenocarcinoma in diethylstilbestrol-exposed offspring. Cancer 54(5):869–875PubMedCrossRefGoogle Scholar
  118. Roberts WS, Hoffman MS, Kavanagh JJ, Fiorica JV, Greenberg H, Finan MA, Cavanagh D (1991) Further experience with radiation therapy and concomitant intravenous chemotherapy in advanced carcinoma of the lower female genital tract. Gynecol Oncol 43(3):233–236PubMedCrossRefGoogle Scholar
  119. Robinson JB, Sun CC, Bodurka-Bevers D, Im DD, Rosenshein NB (2000) Cavitational ultrasonic surgical aspiration for the treatment of vaginal intraepithelial neoplasia. Gynecol Oncol 78(2):235–241. doi: 10.1006/gyno.2000.5881 Google Scholar
  120. Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, Clarke-Pearson DL, Insalaco S (1999) Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med 340(15):1144–1153PubMedCrossRefGoogle Scholar
  121. Rubin P, Casarett GW (1968) Clinical radiation pathology, vol 2. W. B. Saunders, PhiladelphiaGoogle Scholar
  122. Rubin SC, Young J, Mikuta JJ (1985) Squamous carcinoma of the vagina: treatment, complications, and long-term follow-up. Gynecol Oncol 20(3):346–353. 0090-8258(85)90216-1[pii]PubMedCrossRefGoogle Scholar
  123. Russell AH, Koh WJ, Markette K, Russell KJ, Cain JM, Tamimi HK, Greer BE, Figge DC (1987) Radical reirradiation for recurrent or second primary carcinoma of the female reproductive tract. Gynecol Oncol 27(2):226–232. 0090-8258(87)90297-6[pii]PubMedCrossRefGoogle Scholar
  124. Rutkowski T, Bialas B, Rembielak A, Fijalkowski M, Nowakowski K (2002) Efficacy and toxicity of MDR versus HDR brachytherapy for primary vaginal cancer. Neoplasma 49(3):197–200PubMedGoogle Scholar
  125. Salama JK, Mell LK, Schomas DA, Miller RC, Devisetty K, Jani AB, Mundt AJ, Roeske JC, Liauw SL, Chmura SJ (2007) Concurrent chemotherapy and intensity-modulated radiation therapy for anal canal cancer patients: a multicenter experience. J Clin Oncol 25(29):4581–4586. doi: 10.1200/JCO.2007.12.0170 Google Scholar
  126. Samant R, Lau B, E C, Le T, Tam T (2007) Primary vaginal cancer treated with concurrent chemoradiation using Cis-platinum. Int J Radiat Oncol Biol Phys 69(3):746–750Google Scholar
  127. Sedlis AR, Robboy SJ (1987) Diseases of the vagina. In: Kurman RJ (ed) Blaustein’s Pathology of the Female Genital Tract, 3rd edn. Springer Verlag, New YorkGoogle Scholar
  128. Shah CA, Goff BA, Lowe K, Peters WA III, Li CI (2009) Factors affecting risk of mortality in women with vaginal cancer. Obstet Gynecol 113(5):1038–1045. doi: 10.1097/AOG.0b013e31819fe844 Google Scholar
  129. Shah AP, Strauss JB, Gielda BT, Zusag TW (2010) Toxicity associated with bowel or bladder puncture during gynecologic interstitial brachytherapy. Int J Radiat Oncol Biol Phys 77(1):171–179. doi: 10.1016/j.ijrobp.2009.04.077 Google Scholar
  130. Sinha B, Stehman F, Schilder J, Clark L, Cardenes H (2009) Indiana University experience in the management of vaginal cancer. Int J Gynecol Cancer 19(4):686–693. doi: 10.1111/IGC.0b013e3181a12e1d Google Scholar
  131. Spanos W Jr, Guse C, Perez C, Grigsby P, Doggett RL, Poulter C (1989) Phase II study of multiple daily fractionations in the palliation of advanced pelvic malignancies: preliminary report of RTOG 8502. Int J Radiat Oncol Biol Phys 17(3):659–661PubMedCrossRefGoogle Scholar
  132. Spanos WJ Jr, Perez CA, Marcus S, Poulter CA, Doggett RL, Steinfeld AD, Grigsby PW (1993) Effect of rest interval on tumor and normal tissue response–a report of phase III study of accelerated split course palliative radiation for advanced pelvic malignancies (RTOG-8502). Int J Radiat Oncol Biol Phys 25(3):399–403PubMedCrossRefGoogle Scholar
  133. Spanos WJ Jr, Clery M, Perez CA, Grigsby PW, Doggett RL, Poulter CA, Steinfeld AD (1994) Late effect of multiple daily fraction palliation schedule for advanced pelvic malignancies (RTOG 8502). Int J Radiat Oncol Biol Phys 29(5):961–967PubMedCrossRefGoogle Scholar
  134. Stafl A, Wilkinson EJ, Mattingly RF (1977) Laser treatment of cervical and vaginal neoplasia. Am J Obstet Gynecol 128(2):128–136PubMedGoogle Scholar
  135. Stock RG, Mychalczak B, Armstrong JG, Curtin JP, Harrison LB (1992) The importance of brachytherapy technique in the management of primary carcinoma of the vagina. Int J Radiat Oncol Biol Phys 24(4):747–753PubMedCrossRefGoogle Scholar
  136. Stock RG, Chen AS, Seski J (1995) A 30-year experience in the management of primary carcinoma of the vagina: analysis of prognostic factors and treatment modalities. Gynecol Oncol 56(1):45–52. doi: 10.1006/gyno.1995.1008 Google Scholar
  137. Stock RG, Chan K, Terk M, Dewyngaert JK, Stone NN, Dottino P (1997) A new technique for performing Syed-Neblett template interstitial implants for gynecologic malignancies using transrectal-ultrasound guidance. Int J Radiat Oncol Biol Phys 37(4):819–825. S0360-3016(96)00558-5[pii]PubMedCrossRefGoogle Scholar
  138. Sun SS, Chen TC, Yen RF, Shen YY, Changlai SP, Kao A (2001) Value of whole body 18F-fluoro-2-deoxyglucose positron emission tomography in the evaluation of recurrent cervical cancer. Anticancer Res 21(4B):2957–2961PubMedGoogle Scholar
  139. Syed AMN, Puthawala AA, Neblett DL, Disaia PJ, Berman ML, Rettenmaier M, Nalick R, McNamara C (1987) Transperineal interstitial-intracavitary “Syed-Neblett” applicator in the treatment of carcinoma of the uterine cervix. Endocurietherapy/Hyperthermia Oncol 2:1–13Google Scholar
  140. Tabata T, Takeshima N, Nishida H, Hirai Y, Hasumi K (2002) Treatment failure in vaginal cancer. Gynecol Oncol 84(2):309–314. doi: 10.1006/gyno.2001.6520 Google Scholar
  141. Tarraza MH Jr, Muntz H, Decain M, Granai OC, Fuller A Jr (1991) Patterns of recurrence of primary carcinoma of the vagina. Eur J Gynaecol Oncol 12(2):89–92PubMedGoogle Scholar
  142. Tavassoli FA, Norris HJ (1979) Smooth muscle tumors of the vagina. Obstet Gynecol 53(6):689–693PubMedGoogle Scholar
  143. Taylor MB, Dugar N, Davidson SE, Carrington BM (2007) Magnetic resonance imaging of primary vaginal carcinoma. Clin Radiol 62(6):549–555. doi: 10.1016/j.crad.2007.01.008 Google Scholar
  144. Tjalma WA, Monaghan JM, de Barros Lopes A, Naik R, Nordin AJ, Weyler JJ (2001) The role of surgery in invasive squamous carcinoma of the vagina. Gynecol Oncol 81(3):360–365. doi: 10.1006/gyno.2001.6171 Google Scholar
  145. Townsend DE, Levine RU, Crum CP, Richart RM (1982) Treatment of vaginal carcinoma in situ with the carbon dioxide laser. Am J Obstet Gynecol 143(5):565–568. 0002-9378(82)90548-8[pii]PubMedGoogle Scholar
  146. Tran PT, Su Z, Lee P, Lavori P, Husain A, Teng N, Kapp DS (2007) Prognostic factors for outcomes and complications for primary squamous cell carcinoma of the vagina treated with radiation. Gynecol Oncol 105(3):641–649. doi: 10.1016/j.ygyno.2007.01.033 Google Scholar
  147. Tyree WC, Cardenes H, Randall M, Papiez L (2002) High-dose-rate brachytherapy for vaginal cancer: learning from treatment complications. Int J Gynecol Cancer 12(1):27–31PubMedCrossRefGoogle Scholar
  148. Urbanski K, Kojs Z, Reinfuss M, Fabisiak W (1996) Primary invasive vaginal carcinoma treated with radiotherapy: analysis of prognostic factors. Gynecol Oncol 60(1):16–21. doi: 10.1006/gyno.1996.0004 Google Scholar
  149. Van der Zee J, Kleynen CE, Nuyttens JJ, Ansink AC (2008) Hyperthermia to improve results in vaginal cancer. Radiother Oncol 88(2):286–287. doi: 10.1016/j.radonc.2008.01.020 Google Scholar
  150. Whitney CW, Sause W, Bundy BN, Malfetano JH, Hannigan EV, Fowler WC Jr, Clarke-Pearson DL, Liao SY (1999) Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol 17(5):1339–1348PubMedGoogle Scholar
  151. Woodruff JD, Parmley TH, Julian CG (1975) Topical 5-fluorouracil in the treatment of vaginal carcinoma-in situ. Gynecol Oncol 3(2):124–132PubMedCrossRefGoogle Scholar
  152. Xiang EW, Shu-mo C, Ya-qin D, Ke W (1998) Treatment of late recurrent vaginal malignancy after initial radiotherapy for carcinoma of the cervix: an analysis of 73 cases. Gynecol Oncol 69(2):125–129. doi: 10.1006/gyno.1998.4975 Google Scholar
  153. Zaino RJ, Robboy SJ, Kurman RJ (2002) Diseases of the vagina. In: Kurman RJ (ed) Blaustein’s Pathology of the Female Genital Tract, 5th edn edn. Springer Verlag, New York, pp 151–206Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Higinia R. Cardenes
    • 1
  • Jennifer E. Zook
    • 1
  • David L. Andolino
    • 1
  1. 1.Department of Radiation OncologyIndiana University School of MedicineIndianapolisUSA

Personalised recommendations