Follow-up/Toxicity

Question 1

What are the acute RT toxicities of the vulva, pelvis, and inguinal nodes?

Answer 1

Acute RT toxicities of the vulva, pelvis, and inguinal nodes include severe RT dermatitis of the vulva and groins (which results in need for Tx interruption), n/v, diarrhea, urethritis, cystitis, and myelosuppression. Strongly consider performing skin checks in the groin and vulvar sites weekly while the pt is on the Tx table before Tx begins.

Question 2

What are the late RT toxicities associated with the vulva and inguinal nodes?

Answer 2

Late RT toxicities of the vulva, pelvis, and inguinal nodes include vaginal atrophy, itching and discharge, SBO, lymphedema, and femoral neck fracture.

Question 3

Estimate the risk of femoral neck fracture after 50 Gy.

Answer 3

50 Gy to the femoral neck is associated with an 11% risk of fracture at 5 yrs. (Grisby JS et al., Med Dos 2004)

Question 4

What is the NCCN (2018)-recommended f/u frequency post Tx?

Answer 4

q3–6 mos for 2 yrs, q6–12 mos for 3 yrs, then annually.