Table 1 Clinical outcome of Radiotherapy in selected studies
Author and year publication | N | Median follow up (mo) | RT intent | RT total dose (Gy) | Toxicity | DFS (mo) | OS (mo) | LC % (mo) | Conclusions |
|---|---|---|---|---|---|---|---|---|---|
Besa et al. 1992 [6] | 2 | 12–66 | 1: Definitive | 44–64 | - | - | - | - | Dose greater than 50 Gy in who is medically unfit for surgery and for organ preservation could be indicated. |
1: Post-operative | |||||||||
Luk et al. 2003 [7] | 1 | 14–174 | 1: Post-operative | 60 TB + 32 IN | Acute: confluent wet desquamation, enteritis grade 2 | 10 | 15 | 100 (24) | The results confirmed the useful role of radiotherapy in the management of extramammary Paget’s disease. |
Late: ≤ grade 2 skin atrophy | |||||||||
Son et al. 2005 [8] | 3 | 6-96 | 2: Definitive | A) 55.8 1ary | Acute: Dermatitis grade 2–3 | A)12 | A) - | 100 A)(24) | RT is of benefit in some selected cases of EMPD. |
B)- | B)- | B)(6) | |||||||
C)96 | C)- | C)(96) | |||||||
Late: ≤ grade 2 skin atrophy | |||||||||
B) 81.6 1ary + 45.6 IN | |||||||||
1: Post-operative | |||||||||
C) 55.8 TB | |||||||||
Tanaka et al. 2009 [9] | 2 | 18-84 | 2: Definitive | 60 | - | A) 18 | A)- | 100 A)(18) | EMPD is an uncommon neoplasm without any effective treatment. |
B) 84 | B)- | B)(84) | |||||||
Hata et al. 2011 [10] | 12 | 8–133 | 4: Definitive | 45–70.2 Gy (60) | Acute: ≤ Grade 3 hematologic toxicity, dermatitis, cystitis, enteritis, urethritis | 24 | (100 %) 24 mo | 100 % (2–9) | RT is safe and effective for patients with EMPD. It appears to contribute to prolonged survival as a result of good tumor control. |
8: Post-operative | |||||||||
Late: telangiectasia | |||||||||
Hata et al. 2012 [11] | 7 | 18–150 | 7: Definitive | 59.4–70.2 | Acute: ≤ Grade 3 hematologic toxicity, dermatitis, cystitis, enteritis, urethritis | 58 % (36) | 92 % (36) | 71 % (36) | Radiation therapy is effective and safe, and appears to offer a curative treatment option for patients with EMPD. |
46 % (60) | 79 % (60) | (60) | |||||||
Late: ≤ Grade 3 telangiectasia | |||||||||
Cai et al. 2013 [2] | 5 | 7–169 | 1: Pre-operative | 57–60 | Acute, Late: Acceptable ≤ Grade 3 | - | 70.8 mo (Invasive) 21.3 mo (associated with adnexal adenocarcinoma) | - | Intraepithelial EMPDV accounted for the majority of primary cases and had a better prognosis. |
4: Post-operative | |||||||||
Surgical excision was the standard curative treatment for EMPDV. Radiotherapy was an alternative choice | |||||||||
for patients with medical contradiction or surgical difficulties. Postoperative radiotherapy could be considered | |||||||||
in cases with positive surgical margin or lymph node metastasis. Recurrence was common and repeated excision was often necessary. | |||||||||
Hata et al. 2014 [12] | 14 | 2–174 | 10: Definitive | 45–80.2 (60) | Acute: ≤grade 2 hematologic toxicities, dermatitis, colitis, cystitis | 54 % (36) | 62 % (60) | 88 % (36) | Radiation therapy is safe and effective for patients with EMPD. It appeared to contribute to prolonged survival owing to good tumor control, and to be a promising curative treatment option. |
46 % (60) | |||||||||
4: Post-operative | |||||||||
Late: ≤ Grade 3 telangiectasia | |||||||||
Itonaga et al. 2014 [15] | 7 | Median 71.4 | 2: Definitive | 50 | Acute, Late: Acceptable ≤ Grade 3 | 91.7 % (60) | 84.3 % (60) | 91.7 % (60) | Radiotherapy yielded good local control and survival, which suggests that it was effective for patients with EMPD and in particular medically inoperable EMPD. |
2: Post-operative | |||||||||
3: after surgical relapse | |||||||||
Hata et al. 2015 [16] | 4 | 2–109 | 4: Post-operative | 45–64.8 | Acute: ≤ grade 2 dermatitis, grade 1 colitis and cystitis | 92 % (36) | 92 % (36) | 100 % (38) | Postoperative radiation therapy is safe and effective in maintaining local control in patients with EMPD. |
71 % (60) | 62 % (60) | ||||||||
Late: grade 1 telangiectasia |