How would you approach a vulvar SCC with extension to the anal sphincter and inguinal nodes, 10 years after definitive chemoRT+brachy for a cervical cancer?

I have treated few in this situation. Limited to treating vulva, anal canal with the inguinal region with boost to GTV to 66 Gy EQ2 dose with concurrent cisplatinum, avoided any prophylactic nodal region including mesorectum or pelvic nodal region.

Recently had a similar case to the above. Cervical cancer treatment ~20-30 years ago with EBRT + BT who presented with unresectable vulvar SCC.

Did 64 Gy/32 to primary, 50 Gy to groins, no elective pelvic nodal. She did have a solitary pelvic LN that was PET/CT avid which I SBRT'd to 40 Gy to GTV, 35...