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?

Topics: Radiation Oncology • Gynecologic Cancers • Vulvar Cancer

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.

Answer from: Radiation Oncologist at Community Practice

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.

Comments

Radiation Oncologist at St Vincent Radiation Oncology
The primary disease was never macroscopic, but mul...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
similar dose to involved primary with close margin...

Answer from: Radiation Oncologist at Academic Institution

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 ...

Comments

Radiation Oncologist at St Vincent Radiation Oncology
Thank you. These were punch biopsies only. Yes, so...

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