What doses would you treat the primary and lymph nodes in node positive vulvar cancer patient with incidentally found focal SCC in a field of VIN3?
Surgeon is not planning vulvectomy, since biopsies showed 2 mm depth of invasion.
Also tumor board felt dose to the primary site should be only about 50-54 Gy with concurrent chemotherapy.
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
I would treat the primary and inguinal nodes if no additional surgery and SNLN planned.
Dose to primary is a function of microscopic or macroscopic disease left behind: 54-56 Gy if microscopic but 60 or above if macroscopic.
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Radiation Oncology · University of Texas MD Anderson Cancer Center
Answered on
Not a simple question to answer with the available information but will try. Unusual to have so much nodal disease in a patient with just focal invasion in VIN3, so I would worry that there is residual invasive disease. Was there invasive disease near the margins of the excision? VIN3 that could be ...
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