This protocol covers squamous cell carcinoma of the vulva that is locally advanced — staged at ≥T3 and/or ≥N2 — or that is unresectable, including tumors that would otherwise require exenterative surgery with stoma formation.
Advanced stage in this context is defined as clinical ≥T3 and/or ≥N2 disease. Primary chemoradiotherapy is the treatment of choice for patients with unresectable disease and is also the preferred approach for tumors whose surgical management would otherwise necessitate exenteration with stoma.
The recommended strategy for this population involves primary definitive chemoradiotherapy delivered at a specialised gynecological radiotherapy centre.
The primary clinical endpoint is complete remission of the vulvar tumor, assessed at 12 weeks following completion of treatment.
DOI: 10.1136/ijgc-2023-004486
Throughout these recommendations, advanced stage of disease is defined as clinical ≥T3 and/or ≥N2 [V, B].
Primary chemoradiotherapy is the treatment of choice in patients with unresectable disease and should be considered for tumors which would otherwise need exenterative surgery with stoma formation [III, B].
Assessment of response should be performed at 12 weeks following completion of treatment (clinically, imaging and/or biopsy if residual tumor is suspected).
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