Background: Concurrent chemoradiotherapy composed of pelvic external beam radiotherapy (PEBRT) with weekly chemotherapy plus intracavitary brachytherapy (ICBT) remains to be the treatment of choice for locally advanced cervical cancer (LACC). However, some patients are not suitable to have ICBT right after pelvic radiation. Locally, active chemotherapy is being given to these patients until they can undergo the procedure. Objective: The aim of the study was to determine the impact of ICBT in the treatment and survival outcomes of cervical cancer and to compare it with active chemotherapy. Methodology: This was a retrospective study of patients with LACC treated with or without brachytherapy in a single institution from January 2002 to December 2017. Results: The 5-year over-all survival (OS) and 5-year recurrence free survival (RFS) of patients with ICBT were both significantly improved compared to those without ICBT (p=0.001 and p=0.038), respectively. Factors that were significantly correlated with adequate response for brachytherapy were non-squamous cell histology (OR 0.65, CI 0.46- 092, p=0.016), initial tumor size of > 5cm (OR 0.41, CI 0.26-0.65, p=0.001), > 50% decrease in the original tumor size at the middle part of PEBRT (OR 1.83, CI 1.2-2.8, p=0.005), > 3 cycles of chemotherapy as radiosensitizers (OR 2.66, CI 1.79- 3.9, p=0.001), > 45 days duration of PEBRT (OR 0.63, CI 0.41-0.97, p=0.04) and > 2 episodes of anemia during PEBRT (OR 0.67, CI 0.52-0.85, p=0.001). Conclusion Brachytherapy offers significant improvement on tumor control and over-all survival for patients with LACC. Active chemotherapy may offer some benefit in terms of delaying tumor recurrence or progression. However, this did not translate to survival impact if the patient was not able to have brachytherapy at all.
brachytherapy ;

Mucoepidermoid Carcinoma (MEC) is an epithelial malignant tumor that was first described as a salivary gland malignancy. Though common in salivary gland, it is extremely rare in the vulva with only 2 cases reported in the English language literature and none yet in the Philippines. Due to its low incidence, prognosis and definitive management is still unclear. This is a case of a 68-year-old woman with a history of vulvar pruritus and vulvar mass at the left labia majora. Punch biopsy and review of slides revealed Invasive Squamous Cell Carcinoma, Non-Keratinizing type. She underwent Radical Vulvectomy and Bilateral Lymph Groin Dissection; Wide Excision of Perineal Area; Protective Transverse Loop Colostomy; Gracilis Myocutaneous Flap with Identification of Right and Left Median Circumflex Artery with a final histopathology report of Primary Cutaneous MEC of the vulva with lymph node metastasis.
Vulva ; Vulvar Diseases ; Biopsy