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How would you manage a bulky primary exophytic vulvar SqCC in a patient with uncontrolled but very long standing HIV disease?
The patient is a female in her 60s, HIV+ since age 19, and has a current CD4 total count of 20. She has a 7 cm primary cancer without involvement of vaginal mucosa but has urethra involvement. She has palpable bilateral inguinal adenopathy and FDG avid left iliac adenopathy. If chemotherapy is not deemed safe for her, how would you approach her treatment?
Answer from: Radiation Oncologist at Community Practice
Would first optimize HIV management and then plan for definitive RT (chemo) based on the CD4 count
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