Do you recommend concurrent cisplatin and gemcitabine with radiotherapy for unresectable vulvar cancer, as described in GOG-279?

We are still doing weekly cisplatinum with a higher dose of RT as there is concern about additional morbidity with the addition of gemzar.

Richman et al., PMID 32981696

The rates of G4 toxicity with the addition of Gemcitabine are concerning to me. 18 out of 52 patients (34.6%) had G4 toxicity per the initial NRG press release. At the time, I figured a proportion of it was related to dermatitis.

Per the recently published JCO paper (Horowitz et al., PMID 38574312) j...