Role of Radiotherapy as Curative Treatment of Extramammary Paget's Disease

Journal Article · Sun May 01 04:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.01.073· OSTI ID:21491709

Hata, Masaharu ^[1]; Omura, Motoko; Koike, Izumi ^[1]; Wada, Hidefumi ^[2]; Miyagi, Etsuko ^[3]; Tayama, Yoshibumi; Odagiri, Kazumasa; Minagawa, Yumiko ^[1]; Ogino, Ichiro ^[4]; Inoue, Tomio ^[1]

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1. Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan)
2. Department of Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan)
3. Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan)
4. Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Kanagawa (Japan)

Purpose: Extramammary Paget's disease (EMPD) is a relatively rare malignancy that usually arises in the genital areas. Wide surgical excision remains the standard and most reliable curative treatment of EMPD. However, surgery is sometimes not possible, because many patients are elderly, and complete excision can be difficult owing to the tumor location. We, therefore, performed a review to determine the role of radiotherapy (RT) for EMPD. Methods and Materials: A total of 22 patients with EMPD in their external genitalia (4 men and 18 women, age 52-94 years at RT) underwent RT with curative intent. Nine patients had regional lymph node metastases. A total dose of 45-70.2 Gy (median, 60) was delivered to the pelvis, including the tumors, in 25-39 fractions (median, 33). Results: In all but 3 patients, the irradiated tumors were controlled during a follow-up period of 8-133 months (median, 42). Of the 22 patients, 13 developed recurrences, including local progression within the radiation field in 3 and lymph node and/or distant metastases outside the radiation field in 10, at 3-43 months after treatment. The 2- and 5-year local progression-free rates were 91% and 84%, respectively. Of the 22 patients, 7 patients had died at 33-73 months after RT. The cause of death was tumor progression in 4, infectious pneumonia in 2, and renal failure in 1 patient. The overall and cause-specific survival rates were 100% for both at 2 years and 53% and 73% at 5 years, respectively. No therapy-related Grade 3 or greater toxicity was observed. Conclusions: RT is safe and effective for patients with EMPD. It appears to contribute to prolonged survival as a result of good tumor control.

• OSTI ID: 21491709
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 80; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
DISEASES
FAILURES
FEMALE GENITALS
KIDNEYS
LYMPH NODES
LYMPHATIC SYSTEM
MALE GENITALS
MEDICINE
METASTASES
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PELVIS
PNEUMONIA
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM DISEASES
SURVIVAL CURVES
THERAPY