Dose-escalated intensity modulated radiation therapy in patients with locally-advanced vulvar cancer - does it increase response rate?

•Median dose to the vulva was 66.0 Gy for definitive and 59.4 Gy for preoperative IMRT.•The rates of cCR and pCR were 48% and 31% in GOG 101, 64% and 50% in GOG 205, and 76% and 70% in the present study.•Patients node negative on imaging received 45–50 Gy to the groin without biopsy.•No isolated inguinal failures were observed in patients that were node negative on imaging.•On multivariate analysis, cCR predicted for disease-free survival and pCR predicted for OS.