tecan and cisplatin in the management of patients with vaginal squamous cell cancer (SCC). Two patients with International Federation of Obstetrics and Gynecology (FIGO) stage I and one patient with FIGO stage II vaginal SCC

Vaginal cancer is a rare gynecological malignancy, mainly treated by radiotherapy and surgery. However, the effect of neoadjuvant chemotherapy on patients with vaginal cancer has not been extensively evaluated. The aim of the present study was to assess the feasibility and efficacy of irinotecan and cisplatin in the management of patients with vaginal squamous cell cancer (SCC). Two patients with International Federation of Obstetrics and Gynecology (FIGO) stage I and one patient with FIGO stage II vaginal SCC were treated with irinotecan (240 mg) and cisplatin (100 mg) every 3-4 weeks. The effect of chemotherapy after 2-4 courses was assessed and the next step of treatment was determined according to the outcome. In the present study, all 3 patients had complete remission after 2-4 courses of chemotherapy. In case 1, the patient received a total of 6 courses of chemotherapy and had no recurrence after 45 months of follow-up. In case 2, the patient received 4 courses of chemotherapy and partial vaginal resection, and had no recurrence after 48 months of follow-up. In case 3, the patient underwent laparoscopic radical surgery and peritoneal vaginoplasty after 2 courses of chemotherapy, and no residual tumors were identified in the resected tissues on postoperative pathological examination. Effective neoadjuvant chemotherapy may decrease the size of the tumor, induce tumor regression, or even achieve pathologically‐confirmed complete tumor eradication. Thus, neoadjuvant chemotherapy with irinotecan combined with cisplatin is a feasible treatment for patients with early-stage vaginal SCC. In the present study, all the patients achieved good therapeutic results following chemotherapy. Introduction Vaginal cancer is a rare disease, accounting for only 2% of all gynecological malignancies (1). Squamous cell carcinoma (SCC) is the most common type of vaginal cancer accounting for 90% of primary vaginal carcinomas (2). The incidence of SCC increases with age, with the peak age being 70-79 years. However, 30% of the patients are aged <60 years (3). The diagnosis of primary vaginal carcinoma should exclude synchronous cervical, vulval or urethral cancer (4). There is currently no consensus regarding the treatment of vaginal carcinoma. Surgery and radiotherapy are mainly used for patients with stage I disease. Good 5-year survival rates have been reported in patients with stage II or higher vaginal carcinoma who are treated by radiotherapy. However, traditional radiotherapy is associated with several side effects, such as irradiation injury to the bladder and rectum, vaginal stenosis and dyspareunia, with severe compromise of the patients' quality of life (5,6). Treatment individualization has been recommended for early-stage vaginal cancer. Surgery has achieved satisfactory results for patients with stage I vaginal carcinoma (7,8). It was reported that surgery following neoadjuvant chemotherapy achieved a good therapeutic effect (9-12). However, the effect of chemotherapy on vaginal SCC has not been extensively evaluated and the majority of available data are derived from studies with small-sized samples or case reports, without a universal consensus regarding the chemotherapy regimens. Neoadjuvant chemotherapy for cervical cancer is currently considered to be efficient (13-15). It has been suggested that, as the vagina and the cervix are lined with the same type of squamous cell epithelium, the same risk factors are present in both cervical and vaginal carcinomas (16). The aim of the present study was to evaluate the effect of neoadjuvant chemotherapy on patients with primary vaginal SCC.