Advances in the treatment of gynecologic malignancies. Part 1: Cancers of the cervix and vulva.

Two recent multicenter randomized trials have greatly advanced our understanding of the role of postoperative radiation therapy in operable cervical cancer. In locally advanced cervical cancer, such studies have shown a significant improvement in survival with the use of concurrent cisplatin-based chemoradiotherapy and have redefined standard therapy for women with this presentation. In vulvar cancer, adjuvant chemoradiotherapy is emerging as an effective therapeutic approach, permitting less morbid surgery. Although the results of treatment with concurrent chemoradiotherapy are encouraging in both cervical and vulvar cancer, efforts to minimize the associated toxicity are needed.