Brachytherapy in vulvar cancer: Clinical outcome and safety from a single center experience

Oleszczuk A, Strnad V, Lotter M, Kreppner S, Strnad A, Frei C, Weissmann T, Schweizer C, Fietkau R, Corradini S, Schubert P, Karius A, Merten R (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Brachytherapy Elsevier

DOI: 10.1016/j.brachy.2026.03.002

Abstract

Objective: To report clinical outcomes and toxicity of interstitial brachytherapy (IBT), with or without external beam radiotherapy, in a predominantly frail, multimorbid cohort of patients with locally advanced vulvar cancer, analyzed according to treatment intent and clinical setting. Methods: We analyzed 47 patients with vulvar malignancies treated between 1998 and 2024 with pulse dose rate-IBT, either postoperatively or with definitive intent. Fifteen patients received pulse dose rate-IBT alone (median total dose of 57.2 Gy, range, 44.7–67.2), while 32 patients underwent combined external beam radiotherapy followed by an IBT boost (median total dose of 61.4 Gy; range, 50.7–68.1). Median age was 67 years (range, 38–90). Survival outcomes were estimated using Kaplan–Meier methods. Results: Median follow-up was 2.2 years (range, 4–210). Two- and five-year overall survival rates were 58.2% and 45.7%, and disease-free survival rates were 62.5% and 53.1%, respectively. Concurrent chemotherapy was administered to 22/47 (47%) patients and was not completed in 7/22 (32%). In a predefined subgroup treated with curative intent for primary vulvar cancer, five-year overall survival, disease-free survival, and cumulative local recurrence rate were 61.7%, 66.7%, and 29.3%, respectively. Severe toxicity (≥grade 3), including ulceration, occurred in 14.2% of patients. Conclusion: In this real-world cohort, interstitial brachytherapy was feasible with a low rate of severe toxicity. Despite a frail, multimorbid patient population, acceptable local control was achieved. With appropriate patient selection, IBT may represent a viable option to improve local control while limiting mucosal toxicity.

Authors with CRIS profile

Annika Oleszczuk Department of Radiation Oncology Vratislav Strnad Department of Radiation Oncology Stephan Kreppner Department of Radiation Oncology Charlotte Frei Department of Radiation Oncology Thomas Weissmann Department of Radiation Oncology Claudia Schweizer Department of Radiation Oncology Rainer Fietkau Lehrstuhl für Strahlentherapie Stefanie Corradini Department of Radiation Oncology Philipp Schubert Department of Radiation Oncology Andre Karius Department of Radiation Oncology Ricarda Merten Department of Radiation Oncology

Involved external institutions

Klinikum Forchheim – Fränkische Schweiz gGmbH DE Germany (DE)

How to cite

APA:

Oleszczuk, A., Strnad, V., Lotter, M., Kreppner, S., Strnad, A., Frei, C.,... Merten, R. (2026). Brachytherapy in vulvar cancer: Clinical outcome and safety from a single center experience. Brachytherapy. https://doi.org/10.1016/j.brachy.2026.03.002

MLA:

Oleszczuk, Annika, et al. "Brachytherapy in vulvar cancer: Clinical outcome and safety from a single center experience." Brachytherapy (2026).

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