How do you approach the nodal treatment of vaginal cancer using IMRT or more specifically in what situations do you modify elective nodal coverage?

For instance, if you have anal canal involvement, do you cover the entire mesorectum? Any other adjacent organ invasion that would lead to modification of your elective coverage?

Answer from: Radiation Oncologist at Academic Institution

The nodal target volume should reflect the distribution of disease in vagina and paravaginal tissues. All vaginal cancers generally require treatment of at least the internal and external iliac nodes. For apical cancers, the presacral nodes may be included. Cancers that involve the distal vagina (ne...

Comments

Radiation Oncologist at Central Alabama Radiation Oncology LLC
Would you electively cover the vulva?

Radiation Oncologist at Varian Medical Systems/Allegheny health network
We would not cover the vulva electively.

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How do you approach the nodal treatment of vaginal cancer using IMRT or more specifically in what situations do you modify elective nodal coverage?

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