What is the role of a simultaneous integrated boost in vulvar cancer to the primary and nodes?  

We typically do a SIB at 2 Gy per fraction to the vulvar GTV and nodes and then do a sequential boost to follow (CTV is treated at 1.8 to CTV in 25 fractions). Presumably, the nodes could be safely treated at a higher dose per fraction since there is typically not a critical structure in close proxi...

The following is for gross disease: For vulvar cases, I do SIB for the lymph nodes. 60 Gy in 25 fractions to inguinal LNs (unless close to skin) and pelvic lymph nodes, as tolerated based on bowel constraints. For pelvic lymph nodes medial to lower pelvic vessels and in close proximity to the non-d...