In locally advanced squamous cell vulvar carcinoma, researchers aimed to determine whether or not timely completion of radiation therapy affected overall survival (OS). Women more than or equal to 18 years with squamous cell vulvar carcinoma at stages II–IVA were identified using the National Cancer Database from 2004–2017. To this end, they considered female patients with their first course of treatment for vulvar cancer tto o be either radiation therapy (RT) or a chemotherapy concurrent chemoradiation (CRT). The primary endpoint was overall survival in relation to the length of time it took to finish radiation treatment. A total of 2,378 females were found (n = 856 RT and n = 1,522 CRT). 

The median age was 67 (interquartile range: 56-78), and the majority of patients were white (86.35%) with late-stage illness (72.29%). The average radiation exposure was 5,720 c-Gray (IQR 5,040–6,300). Survival was lower among patients whose radiation treatment was delayed by more than 7 days compared to those whose treatment was delayed by less than 7 days (unadjusted HR 1.183 [95% CI: 1.066-1.313], P = 0.0016). In addition, death risk was higher when delays lasted more than 14 days (unadjusted HR: 1.263 [95%CI:1.126-1.416], P<0.0001) compared to when they lasted less than 14 days. In both RT (median OS: 34.9 months vs. 21.6 months, P<0.01) and CRT (median OS: 58 months vs. 41.3 months, P<0.01) settings, survival was better for patients who had a delay of 7 versus 7 days. 

As compared to stage II, the risk of dying from IVA stage disease was significantly higher (HR 1.759 [95% CI 1.517-2.039], P <0.0001). Completed radiation therapy with a delay of fewer than  7 days is related with better overall survival, and this benefit is shown even when chemotherapy is administered at the same time. This suggests that, for locally advanced vulvar can.

Source: sciencedirect.com/science/article/abs/pii/S0090825822018388