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What is your recommended radiation field in early stage vulvar cancer (T1a-b) with myelosuppression, inconclusive SLNBx, and persistent positive margins?
Bone marrow preservation is important due to poor hematologic function. Chemotherapy is not possible as well.
Answer from: Radiation Oncologist at Community Practice
Would favor vulva and bilateral groin (limit to medial groin to reduce marrow exposure of femoral region).
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Answer from: Radiation Oncologist at Academic Institution
pT1a with persistently positive margins wouldn't recommend even inguinal RT, just treat vulva. Those patients don't even necessarily need an inguinal nodal evaluation.
pT1b - If no radiographic suspicion, could consider sending the patient for IFLND of the relevant side, and if negative, treat vulv...