Radiation therapy for vulvar cancer: consensus guidelines of the GINECOR working group of the Spanish Society of Radiation Oncology. Part 1: clinical recommendations

• Sofia Cordoba Largo ^[1] ; Isabel Rodriguez Rodriguez ^[2] ; Silvia Rodriguez Villalba ^[9] ; Dina Najjari Jamal ^[3] ; Javier Anchuelo Latorre ^[4] ; Francisco Celada Álvarez ^[10] ; Sonia Garcia Cabezas ^[5] ; Cristina de la Fuente Alonso ^[1] ; Luz Couselo Paniagua ^[6] ; Irene Martínez Montesinos ^[11] ; Elena Villafranca Iturre ^[7] ; Belén Belinchón Olmeda ^[2] ; Dolores Farga Albiol ^[10] ; Paola Andrea Navarrete Solano ^[4] ; María Sánchez Belda ^[8] ; GINECOR Grupo Español de Tumores Ginecológicos de la SEOR
  1. [1] Hospital Universitario Puerta de Hierro

     Hospital Universitario Puerta de Hierro

     Madrid, España

     
  2. [2] Hospital Universitario La Paz

     Hospital Universitario La Paz

     Madrid, España

     
  3. [3] Universitat de Barcelona

     Universitat de Barcelona

     Barcelona, España

     
  4. [4] Hospital Universitario Marqués de Valdecilla

     Hospital Universitario Marqués de Valdecilla

     Santander, España

     
  5. [5] Hospital Universitario Reina Sofia

     Hospital Universitario Reina Sofia

     Cordoba, España

     
  6. [6] Complexo Hospitalario Universitario de Santiago

     Complexo Hospitalario Universitario de Santiago

     Santiago de Compostela, España

     
  7. [7] Hospital Universitario de Navarra

     Hospital Universitario de Navarra

     Pamplona, España

     
  8. [8] Hospital Universitario de Valladolid

     Hospital Universitario de Valladolid

     Valladolid, España

     
  9. [9] Departamento de Oncología Radioterápica, Hospital Clinica Benidorm, Benidorm, Alicante, España
  10. [10] Departamento de Oncología Radioterápica, Hospital Universitario y Politécnico La Fe, Valencia, España
  11. [11] Departamento de Oncología Radioterápica, Complejo Hospitalario de Navarra, Pamplona, España

  Mostrar afiliaciones +
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 7 (July), 2023, págs. 2153-2168
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose The present consensus statement was developed by the GINECOR working group on behalf of the Spanish Society of Radiation Oncology (SEOR). Given the lack of prospective data on the management of vulvar carcinoma, this document provides an up-to-date review of radiotherapy treatment in vulvar cancer and a series of consensus-based recommendations from a group of experts.

    Methods A two-round, online modified Delphi study was conducted to reach consensus treatment recommendations in three clinical settings: 1) adjuvant treatment, 2) locally-advanced vulvar cancer (LAVC), and 3) recurrent disease. After the first round, we comprehensively reviewed the available medical literature from peer-reviewed journals to assess and define the evidence-based treatment options. In the second round, participants were asked to indicate their level of agreement with the preliminary recommendations according to the GRADE (Grade of Recommendation, Assessment, Development, and Evaluation) criteria, as follows: strongly agree; agree; neither agree nor disagree; disagree; strongly disagree.

    Results The main recommendations were as follows: 1) following surgical resection, adjuvant radiotherapy is recommended with the presence of adverse risk factors (primarily positive margins and lymph node involvement); 2) radiotherapy (with or without chemotherapy) should be considered in LAVC; and 3) in recurrent disease, radiotherapy should be individualised on a case-by-case basis. A high level of agreement over 80% was reached.

    Conclusions In the absence of robust clinical data, these final recommendations may help to select the optimal radiotherapy approach for this relatively rare cancer.