Patients with local or regional recurrence after a previous radical operation for vulvar cancer can, in many cases, be cured by radical radiation therapy.
Radiation therapy may be the primary choice of treatment if radiation has not been given previously, but surgery should always be considered.
Small metastases can also be treated with a curative goal, but the possibility for surgery with subsequent radiation should be considered first.
In the case of brain metastases, stereotactic radiation treatment is indicated for 1 to 3 (maximum) metastases which are not too large. For solitary brain metastases, surgery may be considered. Multiple or large brain metastases are treated with total brain irradiation.
Treatment must be individualized, and treatment with the goal of local control may be appropriate even if there may be subclinical spreading to other organs. Margins and total dose must be adapted according to grade of risk and time perspective.
- Limited recurrence (is a heterogeneous group).
- Curative or palliative for local control