{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:13:28Z","timestamp":1790806408107,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T00:00:00Z","timestamp":1534982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study systematically reviews the recent literature on the role of definitive radiotherapy (RT) in the management of vaginal cancer (VC) and presents comprehensive data on clinical outcomes and toxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors performed a literature search using PubMed (2007\u20132016) to identify all prospective and retrospective studies that have been published on RT in invasive VC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 199 identified studies, 13 met the inclusion criteria. All studies had a retrospective design. Overall, 793 patients (median, 45; range, 26\u2013138) were included. A high heterogeneity was found across studies in terms of RT techniques, assessment criteria, and reported outcomes. The majority of the patients were treated with a combination of external beam RT and brachytherapy (74.2%). Acute and late grade \u22653 toxicity rates ranged from 0.0% to 24.4% (median, 8.7%) and from 0.0% to 22.5% (median, 12.8%), respectively. The 5-year local control rates ranged between 39% and 79%. The 5-year overall survival ranged between 34% and 71.0% (median, 63.5%). Early stage of the disease (International Federation of Gynecology and Obstetrics stages I\u2013II vs. III\u2013IV), small tumor size (&amp;lt;4 cm), previous hysterectomy, high pretreatment\/treatment hemoglobin levels (\u226512\/12.5 mg\/dL), and patients\u2019 age &amp;lt;70 or &amp;lt;64 years were correlated with better clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Only retrospective studies, in a limited number, have been published on RT in VC in the past decade, with significant heterogeneity in terms of treatment characteristic and evaluation criteria. Clinical results were strongly influenced by tumor stage. Prospective randomized studies are needed to improve patients\u2019 outcomes, especially in advanced-stage disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for Practice<\/jats:title><jats:p>This study systematically reviews the recent literature on the role of definitive radiotherapy in the management of vaginal cancer and presents comprehensive data on clinical outcome and toxicity. The prognosis of patients is dismal, with a 5-year overall survival of approximately 50%. Early stage of the disease, small tumor size, previous hysterectomy, high pretreatment\/treatment hemoglobin levels, and patients\u2019 age were correlated with a better clinical outcome. A brachytherapy boost should be delivered, especially in patients with higher-stage disease. The addition of concurrent weekly cisplatin should be considered in most patients, and transfusion should be used to maintain high hemoglobin levels.<\/jats:p><\/jats:sec>","DOI":"10.1634\/theoncologist.2017-0546","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T11:05:19Z","timestamp":1535022319000},"page":"132-141","source":"Crossref","is-referenced-by-count":16,"title":["Definitive Radiotherapy in Invasive Vaginal Carcinoma: A Systematic Review"],"prefix":"10.1093","volume":"24","author":[{"given":"Sara","family":"Guerri","sequence":"first","affiliation":[{"name":"Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Division of Radiology, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Perrone","sequence":"additional","affiliation":[{"name":"Oncologic Gynecology Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milly","family":"Buwenge","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Ferioli","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Macchia","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, General Oncology Unit, Giovanni Paolo II Foundation, Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Tagliaferri","sequence":"additional","affiliation":[{"name":"Gemelli Advanced Radiation Therapy Center, Fondazione Policlinico Universitario \u201cA. Gemelli,\u201d Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Ferrandina","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Fondazione Policlinico Universitario \u201cA. Gemelli,\u201d Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"},{"name":"Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Galuppi","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela D.","family":"Andrulli","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, IRCCS CROB, Rionero in Vulture, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rezarta","family":"Frakulli","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Cammelli","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Arcelli","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierandrea","family":"De Iaco","sequence":"additional","affiliation":[{"name":"Oncologic Gynecology Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio G.","family":"Morganti","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,8,23]]},"reference":[{"key":"2021122506115790300_onco12655-bib-0001","doi-asserted-by":"crossref","first-page":"74","DOI":"10.3322\/canjclin.55.2.74","article-title":"Global cancer statistics, 2002","volume":"55","author":"Parkin","year":"2005","journal-title":"CA Cancer J Clin"},{"key":"2021122506115790300_onco12655-bib-0002","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S0020-7292(03)90114-7","article-title":"Carcinoma of the vagina","volume":"83","author":"Beller","year":"2003","journal-title":"Int J Gynaecol Obstet"},{"key":"2021122506115790300_onco12655-bib-0003","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1097\/IGC.0000000000000743","article-title":"Role of radical surgery in early stages of vaginal cancer\u2013our experience","volume":"26","author":"Jain","year":"2016","journal-title":"Int J Gynecol Cancer"},{"key":"2021122506115790300_onco12655-bib-0004","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.ijrobp.2004.09.032","article-title":"Definitive radiation therapy for squamous cell carcinoma of the vagina","volume":"62","author":"Frank","year":"2005","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2021122506115790300_onco12655-bib-0005","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1034\/j.1600-0412.2001.080004355.x","article-title":"Radiotherapy alone for invasive vaginal cancer: Outcome with intracavitary high dose rate brachytherapy versus conventional low dose rate brachytherapy","volume":"80","author":"Kucera","year":"2001","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2021122506115790300_onco12655-bib-0006","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/0360-3016(95)02394-1","article-title":"Definitive radiotherapy for carcinoma of the vagina: Outcome and prognostic factors","volume":"35","author":"Chyle","year":"1996","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2021122506115790300_onco12655-bib-0007","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ejogrb.2006.05.005","article-title":"Concomitant radiotherapy and hyperthermia for primary carcinoma of the vagina: A cohort study","volume":"133","author":"Aktas","year":"2007","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2021122506115790300_onco12655-bib-0008","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.radonc.2007.09.015","article-title":"Exclusive radiotherapy for primary squamous cell carcinoma of the vagina","volume":"85","author":"Crevoisier","year":"2007","journal-title":"Radiother Oncol"},{"key":"2021122506115790300_onco12655-bib-0009","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.ygyno.2007.01.005","article-title":"Primary adenocarcinoma of the vagina not associated with diethylstilbestrol (DES) exposure","volume":"105","author":"Frank","year":"2007","journal-title":"Gynecol Oncol"},{"key":"2021122506115790300_onco12655-bib-0010","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.ygyno.2007.01.033","article-title":"Prognostic factors for outcomes and complications for primary squamous cell carcinoma of the vagina treated with radiation","volume":"105","author":"Tran","year":"2007","journal-title":"Gynecol Oncol"},{"key":"2021122506115790300_onco12655-bib-0011","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1007\/s00066-009-1930-y","article-title":"Long-term results of radiotherapy in primary carcinoma of the vagina","volume":"185","author":"Hegemann","year":"2009","journal-title":"Strahlenther Onkol"},{"key":"2021122506115790300_onco12655-bib-0012","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1111\/IGC.0b013e3181a12e1d","article-title":"Indiana University experience in the management of vaginal cancer","volume":"19","author":"Sinha","year":"2009","journal-title":"Int J Gynecol Cancer"},{"key":"2021122506115790300_onco12655-bib-0013","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.ygyno.2013.08.012","article-title":"Primary squamous cell carcinoma of the vagina: Prognostic factors, treatment patterns and outcomes","volume":"131","author":"Hiniker","year":"2013","journal-title":"Gynecol Oncol"},{"key":"2021122506115790300_onco12655-bib-0014","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1007\/s10147-012-0379-7","article-title":"Definitive radiation therapy for invasive carcinoma of the vagina: Impact of high-dose rate intracavitary brachytherapy","volume":"18","author":"Nonaka","year":"2013","journal-title":"Int J Clin Oncol"},{"key":"2021122506115790300_onco12655-bib-0015","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1097\/COC.0000000000000002","article-title":"Outcomes of definitive radiation therapy for primary vaginal carcinoma","volume":"38","author":"Greenwalt","year":"2015","journal-title":"Am J Clin Oncol"},{"key":"2021122506115790300_onco12655-bib-0016","first-page":"1885","article-title":"Concomitant external-beam irradiation and chemotherapy followed by high-dose rate brachytherapy boost in the treatment of squamous cell carcinoma of the vagina: A single-center retrospective study","volume":"36","author":"Laliscia","year":"2016","journal-title":"Anticancer Res"},{"key":"2021122506115790300_onco12655-bib-0017","doi-asserted-by":"crossref","DOI":"10.3802\/jgo.2016.27.e17","article-title":"Definitive treatment of primary vaginal cancer with radiotherapy: Multi-institutional retrospective study of the Korean Radiation Oncology Group (KROG 12-09)","volume":"27","author":"Chang","year":"2016","journal-title":"J Gynecol Oncol"},{"key":"2021122506115790300_onco12655-bib-0018","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1093\/jrr\/rrt028","article-title":"Radiation therapy for primary vaginal carcinoma","volume":"54","author":"Murakami","year":"2013","journal-title":"J Radiat Res"},{"key":"2021122506115790300_onco12655-bib-0019","doi-asserted-by":"crossref","first-page":"e65048","DOI":"10.1371\/journal.pone.0065048","article-title":"Concurrent chemoradiation for vaginal cancer","volume":"8","author":"Miyamoto","year":"2013","journal-title":"PLoS One"},{"key":"2021122506115790300_onco12655-bib-0020","author":"Lee"},{"key":"2021122506115790300_onco12655-bib-0021","author":"PDQ Adult Treatment Editorial Board, National Cancer Institute"}],"container-title":["The Oncologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1634\/theoncologist.2017-0546","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1634\/theoncologist.2017-0546","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/24\/1\/132\/41916956\/oncolo_24_1_132.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/24\/1\/132\/41916956\/oncolo_24_1_132.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T10:44:59Z","timestamp":1720521899000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/oncolo\/article\/24\/1\/132\/6439023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,23]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,8,23]]},"published-print":{"date-parts":[[2019,1,1]]}},"URL":"https:\/\/doi.org\/10.1634\/theoncologist.2017-0546","relation":{},"ISSN":["1083-7159","1549-490X"],"issn-type":[{"value":"1083-7159","type":"print"},{"value":"1549-490X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,1,1]]},"published":{"date-parts":[[2018,8,23]]}}}