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The aim of the study was to investigate the potential of primary (chemo)radiotherapy ((C)RT) with regard to clinical outcome and associated prognostic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A\u00a0total of 39\u00a0patients with squamous cell vulvar cancer receiving primary (C)RT were retrospectively identified through hospital databases. Patient and treatment characteristics as well as outcomes were assessed. Survival statistics were calculated using the Kaplan\u2013Meier method. Univariate analysis was performed using the log-rank test and Spearman\u2019s correlation to evaluate associations between patient or treatment characteristics and survival outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median age at diagnosis was 74\u00a0years (range 38\u201392\u00a0years). Patients had advanced stage disease with 28.2%\/38.5% presenting with FIGO stage\u00a0III\/IV, respectively. All patients received external beam radiotherapy (EBRT) with a\u00a0median dose to the primary tumor of 66\u202fGy EQD2 (range 49.6\u202fGy\u201372.6\u202fGy) and to lymph nodes of 53.1\u202fGy EQD2 (range 44.1\u202fGy\u201367.1\u202fGy). 69.2% received concurrent chemotherapy, mostly cisplatin weekly or mitomycin\/5-fluorouracil. 10.3%\/64.1% showed clinical complete remission (cCR)\/partial remission (cPR) at first follow-up; 7.7% had disease progression. After a\u00a0median follow-up of 25.5 months (range 0.5\u2013132.9 months), 3\u2011year locoregional progression-free survival (LRPFS) and overall survival (OS) were 60.2% and 69.6%, respectively. Age and concurrent chemotherapy were the main prognostic parameters associated with improved oncological outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Definitive (C)RT plays an important role in the management of advanced vulvar cancer with high response rates and satisfactory oncological outcomes. However, there is still room for improvement and future trials are needed to further assess the potential of definitive CRT, especially with regard to possible combinations with immunotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00066-025-02483-z","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T16:22:49Z","timestamp":1762791769000},"page":"516-525","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Role of primary chemoradiotherapy in the management of advanced stage vulvar cancer"],"prefix":"10.1007","volume":"202","author":[{"given":"Lars","family":"Wessel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Vinsensia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Koenigsmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juergen","family":"Debus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2389-5404","authenticated-orcid":false,"given":"Nathalie","family":"Arians","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"2483_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung\u00a0H, Ferlay\u00a0J, Siegel\u00a0RL, Laversanne\u00a0M, Soerjomataram\u00a0I, Jemal\u00a0A et\u00a0al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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J.\u00a0Debus is CEO of the Heidelberg Ion Therapy Center (HIT) and member of the board of directors of Heidelberg University Hospital. J.\u00a0Debus holds an experimental accelerator from IntraOP. N.\u00a0Arians reports speaking honoraria from IF-Kongress Management GmbH and travel grants from the German Society for Senology outside the submitted work. L.\u00a0Wessel, M.\u00a0Vinsensia and T.\u00a0Koenigsmann declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}