Patients with local or regional recurrence after radical surgery for vaginal cancer can in many cases be cured with radical radiation therapy. Radiation therapy is the first choice of treatment if it has not been given previously, but surgery should always be considered.
Small, solitary metastases can also be treated to cure the disease, but surgery with possibly subsequent radiation therapy must be considered first.
For brain metastases, stereotactic radiation therapy is possible for a maximum of 1 to 3 metastases which are not too large. For solitary brain metastases, surgery may be possible. Multiple or large brain metastases are treated with total brain irradiation.
Treatment must be individualized. Treatment aimed at local control may be appropriate even if the there is a risk there may be subclinical spreading to other regions. Margins and total dose must be considered in light of the risk and time perspective.
- Distinct recurrence, heterogenous group
- To cure the disease, or palliate by local control.