Identification and Management of Late Toxicities After Radiation Therapy for Vulvar Cancer

Vulvar cancer is a rare malignancy, with an estimated 6.900 cases diagnosed in 2024, though incidence has been rising in recent years. Radiation plays a critical role in definitive and adjuvant management, however late toxicities including pelvic insufficiency fractures (PIFs), anal/fecal incontinence, sexual dysfunction, cutaneous and sub-cutaneous fibrosis, and lymphedema may significantly impact quality of life in long-term survivors. This article will describe the most commonly encountered late radiation-induced toxicities seen in the management of vulvar cancers and provide practical guidance regarding work-up, and evidence-based management.