Do you treat inguinal lymph nodes for patients with low lying vaginal cancers?

Yes we do. For distal vaginal cancers (not involving vulva) that have no enlarged nodes, we treat the medial inguinal nodes (e.g. nodes medial to the common femoral and saphenous veins) to 45 Gy. We do not treat the nodes lateral to the femoral vein (i.e., along the circumflex v) unless there are suspicious groin nodes or unless the vulva is involved. If the vulva is involved or if there are abnormal inguinal nodes, we treat the lateral nodes as well.

We generally treat any node that is consider...

I agree entirely. Total treatment time is extremely important and it is for this reason that we usually integrate a boost for large nodes although we rarely exceed 210 cGy per fraction if there are critical structures close by (particularly duodenum). It sounds like Sushil and I are fairly close in our dose suggestions although because we typically treat gross nodes using a minimum of 2 Gy/fraction with integrated boosts, our effective doses are still probably somewhat higher, even when taking i...

Yes we do treat bilateral inguinal nodes for distal vaginal cancers. For involved nodes we use SIB technique of 55Gy in 25 fractions for nodal size up to 2 cm. For larger nodes, we add two or three additional fractions.

Our outcome data using this approach for cervical cancer is published in Red Journal. below is the link

http://www.ncbi.nlm.nih.gov/pubmed/25303889?dopt=Abstract&otool=upittlib

Only one minor comment I would make about EQ2 for 55 Gy in 25 fractions when calculated without taking total treatment time is 56 Gy as mentioned but if we consider that treatment is done in 5 weeks instead of 6 weeks then depending on what Tpot we consider for calculation it varies from 58-60 Gy and as mentioned for node larger than 2 cm, we add few more fractions sequentially to make it close to 64-68 Gy depending on size.