Radiation therapy for lymph node metastasis from extramammary Paget's disease

Background Inoperable patients with lymph node metastasis from extramammary Paget's disease (EMPD) have limited curative treatment options. Objective The aim of this study was to review the efficacy and toxicity of radiation therapy for lymph node metastasis from EMPD. Methods Eight EMPD patients with pelvic and inguinal lymph node metastasis, representing a total of 43 metastatic lymph nodes, underwent radiation therapy. Of these eight patients, two received radiation therapy as an initial treatment for EMPD and six for recurrence only in the lymph nodes after they had undergone surgery. Total doses of 45–61.2 Gy (median, 59.4 Gy) were delivered to metastatic lymph nodes in 25–34 fractions (median, 33 fractions). Results Of the 43 metastatic lymph nodes in the eight patients, all but one had no progression at the median follow‐up time of 22 months. The 2‐year local control rates were 86% in all patients and 98% in all metastatic lymph nodes, respectively. No therapy‐related toxicities of grade 3 or greater were observed. Conclusion Radiation therapy is effective and safe, and appears to offer a curative treatment option for lymph node metastasis from EMPD.