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Postoperative radiation therapy for extramammary Paget's disease
Author(s) -
Hata M.,
Koike I.,
Wada H.,
Miyagi E.,
Kasuya T.,
Kaizu H.,
Mukai Y.,
Inoue T.
Publication year - 2015
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.13357
Subject(s) - medicine , radiation therapy , extramammary paget's disease , adjuvant therapy , surgery , malignancy , lymph node , disease , chemotherapy
Summary Background Extramammary Paget's disease ( EMPD ) is a rare cutaneous malignancy that is usually treated with surgery. Patients with positive surgical margins require adjuvant therapy, but there have been few reports on the use of radiation therapy. Objectives To investigate the effectiveness of postoperative radiation therapy in EMPD . Materials and methods Twenty‐one patients with EMPD involving the genitalia underwent radiation therapy as adjuvant therapy after surgery. Ten patients had inguinal lymph node involvement before radiation therapy, but none had distant metastases. A median total dose of 59·4 Gy (range, 45–64·8 Gy) was delivered to the tumour bed in 30 fractions (range, 23–36 fractions). Results At a median follow‐up period of 38 months, all patients had local control. However, six patients had developed distant metastases 6–43 months after radiation therapy. The distant metastasis‐free rates were 66% at 3 years and 55% at 5 years. Inguinal lymph node involvement was a significant risk factor for distant metastases. Four patients died 33–58 months after irradiation; the causes of death were tumour progression in three patients and infectious pneumonia in one. The overall and cause‐specific survival rates were both 92% at 3 years, and 62% and 71% at 5 years, respectively. No therapy‐related toxicities of grade ≥ 3 were observed. Conclusions Postoperative radiation therapy is safe and effective in maintaining local control in patients with EMPD .