Skip to main content
SpringerLink
Log in

Chemotherapy of vulvar cancer: a review

Chemotherapie des Karzinoms der Vulva

  • review article
  • Published:
Wiener klinische Wochenschrift Aims and scope Submit manuscript

Summary

Squamous cell carcinoma of the vulva is a rare disease with good prognosis if diagnosed early. The standard primary therapy is surgery. Neoadjuvant radiation or chemotherapy has been used to achieve resectability of the tumor and to decrease the radicality of the surgery. Chemotherapy with platinum compounds, paclitaxel and targeted therapy (erlotinib) has shown activity. International collaborative trials are needed to identify the best therapeutic strategy for patients with squamous cell cancer of the vulva who are not candidates for primary surgery or concomitant chemoradiation. We review the various treatment options available to patients with advanced or recurrent squamous cell cancer of the vulva.

Zusammenfassung

Das Plattenepithelkarzinom der Vulva ist eine seltene Erkrankung mit guter Prognose bei frühzeitiger Diagnose. Die Standard-Primärtherapie ist die Operation. Eine neoadjuvante Bestrahlung oder Chemotherapie wird zur besseren Resektabilität des Tumors und Verminderung der Radikalität der Operation eingesetzt. Eine Chemotherapie mit Platin enthaltenden Substanzen, Paclitaxel, bzw. eine Targeted Therapie mit Erlotinib hat eine belegte Wirksamkeit.

Internationale Multizenter-Studien werden allerdings benötigt, um die beste Therapie-Strategie für Patientinnen mit einem Plattenepithelkarzinom der Vulva, die nicht Kandidatinnen für eine Primär-Operation oder begleitende Chemo-Radiatio sind, festzulegen. Wir geben einen Überblick über die verschiedenen zur Verfügung stehenden Behandlungsoptionen für Patientinnen mit fortgeschrittenem oder rezidivierendem Plattenepithelkarzinom der Vulva.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10–29.

    Article  PubMed  Google Scholar 

  2. Madsen BS, Jensen HL, van den Brule AJ, Wohlfahrt J, Frisch M. Risk factors for invasive squamous cell carcinoma of the vulva and vagina-population-based case-control study in Denmark. Int J Cancer. 2008;122:2827–34.

    Article  PubMed  CAS  Google Scholar 

  3. Hampl M, Deckers-Figiel S, Hampl JA, Rein D, Bender HG. New aspects of vulvar cancer: changes in localization and age of onset. Gynecol Oncol. 2008;109:340–5.

    Article  PubMed  Google Scholar 

  4. Farias-Eisner R, Berek JS. Current management of invasive squamous carcinoma of the vulva. Clin Geriatr Med. 1993;9:131–43.

    PubMed  CAS  Google Scholar 

  5. Hoffman MS. Squamous-cell carcinoma of the vulva: locally advanced disease. Best Pract Res Clin Obstet Gynaecol. 2003;17:635–47.

    Article  PubMed  Google Scholar 

  6. Hacker NF, Van der Velden J. 1993. Conservative management of early vulvar cancer. Cancer. 71:1673–7.

    Article  PubMed  CAS  Google Scholar 

  7. Stehman FB, Bundy BN, Dvoretsky PM, Creasman WT. Early stage I carcinoma of the vulva treated with ipsilateral superficial inguinal lymphadenectomy and modified radical hemivulvectomy: a prospective study of the gynecologic oncology group. Obstet Gynecol. 1992;79:490–7.

    PubMed  CAS  Google Scholar 

  8. Woelber L, Kock L, Gieseking F, et al. Clinical management of primary vulvar cancer. Eur J Cancer. 47:2011:2315–21.

    Article  PubMed  Google Scholar 

  9. Stroup AM, Harlan LC, Trimble EL. Demographic, clinical, and treatment trends among women diagnosed with vulvar cancer in the United States. Gynecol Oncol. 2008;108:577–83.

    Article  PubMed  CAS  Google Scholar 

  10. de Hullu JA, van der Avoort IA, Oonk MH, van der Zee AG. Management of vulvar cancers. Eur J Surg Oncol. 2006;32:825–31.

    Article  PubMed  Google Scholar 

  11. Boronow RC, Hickman BT, Reagan MT, Smith RA, Steadham RE. Combined therapy as an alternative to exenteration for locally advanced vulvovaginal cancer. II. Results, complications, and dosimetric and surgical considerations. Am J Clin Oncol. 1987;10:171–81.

    Article  PubMed  CAS  Google Scholar 

  12. van Doorn HC, Ansink A, Verhaar-Langereis M, Stalpers L. Neoadjuvant chemoradiation for advanced primary vulvar cancer. Cochrane Database Syst Rev. 2006;CD003752.

  13. Kalra JK, Grossman AM, Krumholz BA, et al. Preoperative chemoradiotherapy for carcinoma of the vulva. Gynecol Oncol. 1981;12:256–60.

    Article  PubMed  CAS  Google Scholar 

  14. Montana GS, Thomas GM, Moore DH, et al. Preoperative chemo-radiation for carcinoma of the vulva with N2/N3 nodes: a gynecologic oncology group study. Int J Radiat Oncol Biol Phys. 2000;48:1007–13.

    Article  PubMed  CAS  Google Scholar 

  15. Levin W, Goldberg G, Altaras M, Bloch B, Shelton MG. The use of concomitant chemotherapy and radiotherapy prior to surgery in advanced stage carcinoma of the vulva. Gynecol Oncol. 1986;25:20–5.

    Article  PubMed  CAS  Google Scholar 

  16. Gerszten K, Selvaraj RN, Kelley J, Faul C. Preoperative chemoradiation for locally advanced carcinoma of the vulva. Gynecol Oncol. 2005;99:640–4.

    Article  PubMed  Google Scholar 

  17. Coon D, Beriwal S, Heron DE, et al. High-dose-rate Rotte "Y" applicator brachytherapy for definitive treatment of medically inoperable endometrial cancer: 10-year results. Int J Radiat Oncol Biol Phys. 2008;71:779–83.

    Article  PubMed  Google Scholar 

  18. Lupi G, Raspagliesi F, Zucali R, et al. Combined preoperative chemoradiotherapy followed by radical surgery in locally advanced vulvar carcinoma. A pilot study. Cancer. 1996;77:1472–8.

    Article  PubMed  CAS  Google Scholar 

  19. Moore DH, Thomas GM, Montana GS, Saxer A, Gallup DG, Olt G. Preoperative chemoradiation for advanced vulvar cancer: a phase II study of the gynecologic oncology group. Int J Radiat Oncol Biol Phys. 1998;42:79–85.

    Article  PubMed  CAS  Google Scholar 

  20. Slevin NJ, Pointon RC. Radical radiotherapy for carcinoma of the vulva. Br J Radiol. 1989;62:145–7.

    Article  PubMed  CAS  Google Scholar 

  21. Perez CA, Grigsby PW, Galakatos A, et al Radiation therapy in management of carcinoma of the vulva with emphasis on conservation therapy. Cancer. 1993;71:3707–16.

    Article  PubMed  CAS  Google Scholar 

  22. Russell AH, Mesic JB, Scudder SA, et al. Synchronous radiation and cytotoxic chemotherapy for locally advanced or recurrent squamous cancer of the vulva. Gynecol Oncol. 1992;47:14–20.

    Article  PubMed  CAS  Google Scholar 

  23. Thomas G, Dembo A, DePetrillo A, et al. Concurrent radiation and chemotherapy in vulvar carcinoma. Gynecol Oncol. 1989;34:263–7.

    Article  PubMed  CAS  Google Scholar 

  24. Wahlen SA, Slater JD, Wagner RJ, et al. Concurrent radiation therapy and chemotherapy in the treatment of primary squamous cell carcinoma of the vulva. Cancer. 1995;75:2289–94.

    Article  PubMed  CAS  Google Scholar 

  25. Berek JS, Heaps JM, Fu YS, Juillard GJ, Hacker NF. Concurrent cisplatin and 5-fluorouracil chemotherapy and radiation therapy for advanced-stage squamous carcinoma of the vulva. Gynecol Oncol. 1991;42:197–201.

    Article  PubMed  CAS  Google Scholar 

  26. Koh WJ, Wallace HJ 3rd, Greer BE, et al. Combined radiotherapy and chemotherapy in the management of local-regionally advanced vulvar cancer. Int J Radiat Oncol Biol Phys. 1993;26:809–16.

    Article  PubMed  CAS  Google Scholar 

  27. Eifel PJ, Morris M, Burke TW, Levenback C, Gershenson DM. Prolonged continuous infusion cisplatin and 5-fluorouracil with radiation for locally advanced carcinoma of the vulva. Gynecol Oncol. 1995;59:51–6.

    Article  PubMed  CAS  Google Scholar 

  28. Cunningham MJ, Goyer RP, Gibbons SK, Kredentser DC, Malfetano JH, Keys H. Primary radiation, cisplatin, and 5-fluorouracil for advanced squamous carcinoma of the vulva. Gynecol Oncol. 1997;66:258–61.

    Article  PubMed  CAS  Google Scholar 

  29. Moore DH. Chemotherapy and radiation therapy in the treatment of squamous cell carcinoma of the vulva: are two therapies better than one? Gynecol Oncol. 2009;113:379–83.

    Article  PubMed  Google Scholar 

  30. Akl A, Akl M, Boike G, Hebert J, Graham J. Preliminary results of chemoradiation as a primary treatment for vulvar carcinoma. Int J Radiat Oncol Biol Phys. 2000;48:415–20.

    Article  PubMed  CAS  Google Scholar 

  31. Evans LS, Kersh CR, Constable WC, Taylor PT. Concomitant 5-fluorouracil, mitomycin-C, and radiotherapy for advanced gynecologic malignancies. Int J Radiat Oncol Biol Phys. 1988;15:901–6.

    Article  PubMed  CAS  Google Scholar 

  32. Han SC, Kim DH, Higgins SA, Carcangiu ML, Kacinski BM. Chemoradiation as primary or adjuvant treatment for locally advanced carcinoma of the vulva. Int J Radiat Oncol Biol Phys. 2000;47:1235–44.

    Article  PubMed  CAS  Google Scholar 

  33. Moore DH, Ali S, Koh WJ, et al. A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a gynecologic oncology group study. Gynecol Oncol. 2012;124:529–33.

    Article  PubMed  CAS  Google Scholar 

  34. Mak RH, Halasz LM, Tanaka CK, et al. Outcomes after radiation therapy with concurrent weekly platinum-based chemotherapy or every 3–4-week 5-fluorouracil-containing regimens for squamous cell carcinoma of the vulva. Gynecol Oncol. 2011;120:101–7.

    Article  PubMed  CAS  Google Scholar 

  35. Tans L, Ansink AC, van Rooij PH, Kleijnen C, Mens JW. The role of chemo-radiotherapy in the management of locally advanced carcinoma of the vulva: single institutional experience and review of literature. Am J Clin Oncol. 2011;34:22–6.

    Article  PubMed  Google Scholar 

  36. Rogers LJ, Howard B, Van Wijk L, et al. Chemoradiation in advanced vulval carcinoma. Int J Gynecol Cancer. 2009;19:745–51.

    Article  PubMed  Google Scholar 

  37. Mulayim N, Foster Silver D, Schwartz PE, Higgins S. Chemoradiation with 5-fluorouracil and mitomycin C in the treatment of vulvar squamous cell carcinoma. Gynecol Oncol. 2004;93:659–66.

    Article  PubMed  CAS  Google Scholar 

  38. Roberts WS, Kavanagh JJ, Greenberg H, et al. Concomitant radiation therapy and chemotherapy in the treatment of advanced squamous carcinoma of the lower female genital tract. Gynecol Oncol. 1989;34:183–6.

    Article  PubMed  CAS  Google Scholar 

  39. Roberts WS, Hoffman MS, Kavanagh JJ, et al. Further experience with radiation therapy and concomitant intravenous chemotherapy in advanced carcinoma of the lower female genital tract. Gynecol Oncol. 1991;43:233–6.

    Article  PubMed  CAS  Google Scholar 

  40. Gadducci A, Cionini L, Romanini A, Fanucchi A, Genazzani AR. Old and new perspectives in the management of high-risk, locally advanced or recurrent, and metastatic vulvar cancer. Crit Rev Oncol Hematol. 2006;60:227–41.

    Article  PubMed  Google Scholar 

  41. Deppe G. Chemotherapy of Gynecologic Cancer. 1st ed. New York: Alan R Liss, Inc. 1984. Yordan EL, Bonomi PD, Wilbanks GD. Chemotherapy of vulvar and vaginal neoplasms, pp. 85–101.

  42. Deppe G. Chemotherapy of Gynecologic. 2nd ed. New York: Alan R Liss, Inc. 1990. Yordan EL, Deppe G, Malviya VK, Bonomi P. Chemotherapy of vulvar and vaginal malignanies, pp. 99–119.

  43. Tomao F, Di Tucci C, Marchetti C, Perniola G, Bellati F, Panici PB. Role of chemotherapy in the management of vulvar carcinoma. Crit Rev Oncol Hematol. 2012;82:25–39.

    Article  PubMed  Google Scholar 

  44. Horowitz NS, Olawaiye AB, Borger DR, et al. Phase II trial of erlotinib in women with squamous cell carcinoma of the vulva. Gynecol Oncol. 2012;127:141–6.

    Article  PubMed  CAS  Google Scholar 

  45. Taylor SGt, Murthy AK, Showel JL, et al. Improved control in advanced head and neck cancer with simultaneous radiation and cisplatin/5-FU chemotherapy. Cancer Treat Rep. 1985;69:933–9.

    PubMed  Google Scholar 

  46. Morris M, Eifel PJ, Lu J, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med. 1999;340:1137–43.

    Article  PubMed  CAS  Google Scholar 

  47. Rose PG, Bundy BN, Watkins EB, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340:1144–53.

    Article  Google Scholar 

  48. Peters WA, 3rd, Liu PY, Barrett RJ, et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol. 2000;18:1606–13.

    PubMed  CAS  Google Scholar 

  49. Cummings B, Keane T, Thomas G, Harwood A, Rider W. Results and toxicity of the treatment of anal canal carcinoma by radiation therapy or radiation therapy and chemotherapy. Cancer. 1984;54:2062–8.

    Article  PubMed  CAS  Google Scholar 

  50. Cummings BJ. Current management of anal canal cancer. Semin Oncology.2005;32:S. 123–8.

    Article  Google Scholar 

  51. Nigro ND, Vaitkevicius VK, Buroker T, Bradley GT, Considine B. Combined therapy for cancer of the anal canal. Dis Colon Rectum. 1981;24:73–5.

    Article  PubMed  CAS  Google Scholar 

  52. Scheistroen M, Trope C. Combined bleomycin and irradiation in preoperative treatment of advanced squamous cell carcinoma of the vulva. Acta Oncol. 1993;32:657–61.

    Article  PubMed  CAS  Google Scholar 

  53. Landoni F, Maneo A, Zanetta G, et al. Concurrent preoperative chemotherapy with 5-fluorouracil and mitomycin C and radiotherapy (FUMIR) followed by limited surgery in locally advanced and recurrent vulvar carcinoma. Gynecol Oncol. 1996;61:321–7.

    Article  PubMed  CAS  Google Scholar 

  54. Sebag-Montefiore DJ, McLean C, et al. Treatment of advanced carcinoma of the vulva with chemoradiotherapy—can exenterative surgery be avoided? Int J Gynecol Cancer. 1994;4:150–5.

    Article  PubMed  Google Scholar 

  55. Jhingran A. Potential advantages of intensity-modulated radiation therapy in gynecologic malignancies. Semin Radiat Oncol. 2006;16:144–51.

    Article  PubMed  Google Scholar 

  56. Beriwal S, Jain SK, Heron DE, de Andrade RS, Lin CJ, Kim H. Dosimetric and toxicity comparison between prone and supine position IMRT for endometrial cancer. Int J Radiat Oncol Biol Phys. 2007;67:485–9.

    Article  PubMed  Google Scholar 

  57. Shimizu Y, Hasumi K, Masubuchi K. Effective chemotherapy consisting of bleomycin, vincristine, mitomycin C, and cisplatin (BOMP) for a patient with inoperable vulvar cancer. Gynecol Oncol. 1990;36:423–7.

    Article  PubMed  CAS  Google Scholar 

  58. Durrant KR, Mangioni C, Lacave AJ, et al. Bleomycin, methotrexate, and CCNU in advanced inoperable squamous cell carcinoma of the vulva: a phase II study of the EORTC Gynaecological Cancer Cooperative Group (GCCG). Gynecol Oncol. 1990;37:359–62.

    Article  PubMed  CAS  Google Scholar 

  59. Achilli C, Palaia I, Perniola G, Donato VD, Marchetti C, Benedetti Panici P. Complete remission after neoadjuvant chemotherapy of an advanced vulvar cancer patient: A case report. J Obstet Gynaecol Res. 2012;38:1036–9.

    Article  PubMed  Google Scholar 

  60. Geisler JP, Manahan KJ, Buller RE. Neoadjuvant chemotherapy in vulvar cancer: avoiding primary exenteration. Gynecol Oncol. 2006;100:53–7.

    Article  PubMed  CAS  Google Scholar 

  61. Domingues AP, Mota F, Durao M, Frutuoso C, Amaral N, de Oliveira CF. Neoadjuvant chemotherapy in advanced vulvar cancer. Int J Gynecol Cancer. 2010;20:294–8.

    Article  PubMed  Google Scholar 

  62. Benedetti-Panici P, Greggi S, Scambia G, Salerno G, Mancuso S. Cisplatin (P), bleomycin (B), and methotrexate (M) preoperative chemotherapy in locally advanced vulvar carcinoma. Gynecol Oncol. 1993;50:49–53.

    Article  PubMed  CAS  Google Scholar 

  63. Narimatsu A, Okada O. A case of FIGO stage IV A vulvar cancer successfully treated by neoadjuvant chemotherapy with continuous intra-arterial infusion (cisplatin, 5-fluorouracil). Gan To Kagaku Ryoho. 24:1997;1161–5.

    PubMed  CAS  Google Scholar 

  64. Wagenaar HC, Colombo N, Vergote I, et al. Bleomycin, methotrexate, and CCNU in locally advanced or recurrent, inoperable, squamous-cell carcinoma of the vulva: an EORTC gynaecological cancer cooperative group study. European organization for research and treatment of cancer. Gynecol Oncol. 2001;81:348–54.

    Article  PubMed  CAS  Google Scholar 

  65. Aragona AM, Cuneo N, Soderini AH, Alcoba E, Greco A, Reyes C, Lekmann S. Tailoring the treatment of locally advanced squamous cell carcinoma of the vulva: neoadjuvant chemotherapy followed by radical surgery: results from a multicenter study. Int J Gynecol Cancer.2012;22:1258–63.

    Article  PubMed  Google Scholar 

  66. Homesley HD, Bundy BN, Sedlis A, Adcock L. Radiation therapy versus pelvic node resection for carcinoma of the vulva with positive groin nodes. Obstet Gynecol. 1986;68:733–40.

    PubMed  CAS  Google Scholar 

  67. Fons G, Hyde SE, Buist MR, et al. Prognostic value of bilateral positive nodes in squamous cell cancer of the vulva. Int J Gynecol Cancer. 2009;19:1276–80.

    Article  PubMed  Google Scholar 

  68. Bellati F, Angioli R, Manci N, et al. Single agent cisplatin chemotherapy in surgically resected vulvar cancer patients with multiple inguinal lymph node metastases. Gynecol Oncol. 2005;96:227–31.

    Article  PubMed  CAS  Google Scholar 

  69. Deppe G, Cohen CJ, Bruckner HW. Chemotherapy of squamous cell carcinoma of the vulva: A review. Gynecol Oncol. 1979;7:345–8.

    Article  PubMed  CAS  Google Scholar 

  70. Trope C, Johnsson JE, Larsson G, Simonsen E. Bleomycin alone or combined with mitomycin C in treatment of advanced or recurrent squamous cell carcinoma of the vulva. Cancer Treat Rep. 1980;64:639–42.

    PubMed  CAS  Google Scholar 

  71. Belinson JL, Stewart JA, Richards AL, McClure M. Bleomycin, vincristine, mitomycin-C, and cisplatin in the management of gynecological squamous cell carcinomas. Gynecol Oncol. 1985;20:387–93.

    Article  Google Scholar 

  72. Thigpen JT, Blessing JA, Homesley HD, Lewis GC Jr. Phase II trials of cisplatin and piperazinedione in advanced or recurrent squamous cell carcinoma of the vulva: a gynecologic oncology group study. Gynecol Oncol. 1986;23:358–63.

    Article  PubMed  CAS  Google Scholar 

  73. Muss HB, Bundy BN, Christopherson WA. Mitoxantrone in the treatment of advanced vulvar and vaginal carcinoma. A gynecologic oncology group study. Am J Clin Oncol. 1989;12:142–4.

    Article  PubMed  CAS  Google Scholar 

  74. Witteveen PO, van der Velden J, et al. Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer—Gynaecological Cancer Group). Ann Oncol. 2009;20:1511–6.

    Article  PubMed  CAS  Google Scholar 

  75. Cormio G, Loizzi V, Gissi F, et al. Cisplatin and vinorelbine chemotherapy in recurrent vulvar carcinoma. Oncology. 2009;7:281–4.

    Article  Google Scholar 

  76. Han SN, Vergote I, Amant F. Weekly paclitaxel/carboplatin in the treatment of locally advanced, recurrent, or metastatic vulvar cancer. Int J Gynecol Cancer. 2012;22:865–8.

    Article  PubMed  Google Scholar 

  77. Belotte J, Awonuga AO, Bolinjkar R, Alexis M, Tabassum F, Deppe G. Platinum-based combination chemotherapy for the treatment of advanced-stage squamous cell carcinoma of the vulva. Obstet Gynecol. 2012;120:458–60.

    Article  PubMed  CAS  Google Scholar 

  78. Olawaiye A, Lee LM, Krasner C, Horowitz N. Treatment of squamous cell vulvar cancer with the anti-EGFR tyrosine kinase inhibitor Tarceva. Gynecol Oncol. 2007;106:628–30.

    Article  PubMed  CAS  Google Scholar 

  79. Bacha OM, Levesque E, Renaud MC, Lalancette M. A case of recurrent vulvar carcinoma treated with erlotinib, an EGFR inhibitor. Eur J Gynaecol Oncol. 2011;32:423–4.

    PubMed  CAS  Google Scholar 

  80. Richard SD, Krivak TC, Beriwal S, Zorn KK. Recurrent metastatic vulvar carcinoma treated with cisplatin plus cetuximab. Int J Gynecol Cancer. 2008;18:1132–5.

    Article  PubMed  CAS  Google Scholar 

  81. Brustmann H. Epidermal growth factor receptor is involved in the development of an invasive phenotype in vulvar squamous lesions, but is not related to MIB—1 immunoreactivity. Int J Gynecol Pathol. 2007;6:481–9.

    Article  Google Scholar 

  82. Berchuck A, Rodriguez G, Kamel A, Soper JT, Clarke-Pearson DL, Bast RC Jr. Expression of epidermal growth factor receptor and HER-2/neu in normal and neoplastic cervix, vulva, and vagina. Obstet Gynecol. 1990;76:381–7.

    PubMed  CAS  Google Scholar 

  83. Johnson GA, Mannel R, Khalifa M, et al. Epidermal growth factor receptor in vulvar malignancies and its relationship to metastasis and patient survival. Gynecol Oncol. 1997;65:425–9.

    Article  PubMed  CAS  Google Scholar 

  84. Monk BJ, Sill MW, Burger RA, Gray HJ, Buekers TE, Roman LD. Phase II trial of bevacizumab in the treatment of persistent or recurrent squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 2009;27:1069–74.

    Article  PubMed  CAS  Google Scholar 

  85. Monk BJ, Willmott LJ, Sumner DA. Anti-angiogenesis agents in metastatic or recurrent cervical cancer. Gynecol Oncol. 2010;116:1816.

    Article  Google Scholar 

Download references

Conflict of interest

All authors declare that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Harper Professional Building, 4160 John R, Suite 721, Detroit, MI, USA

    Gunter Deppe MD & Ira S. Winer MD, PhD

  2. Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, WayneState University School of Medicine, 275 E. Hancock, Detroit, MI, 48201, USA

    Ismail Mert MD & Jimmy Belotte MD

Authors
  1. Gunter Deppe MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ismail Mert MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jimmy Belotte MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ira S. Winer MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ismail Mert MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Deppe, G., Mert, I., Belotte, J. et al. Chemotherapy of vulvar cancer: a review. Wien Klin Wochenschr 125, 119–128 (2013). https://doi.org/10.1007/s00508-013-0338-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00508-013-0338-y

Keywords

Schlüsselwörter

Search

Navigation