So, um, what lessons does this case kind of provide to us about the potential role of definitive radiotherapy for patients who may not be candidate for surgery or, um, systemic therapy based on their comorbidities?

So, you know, one approach that came up was, you know, we're thinking, "How can we best help this patient?" And in cases like this where you're really concerned about quality of life, at the end of the day, for this patient who is medically inoperable, she was, uh, wheelchair-bound, very bulky, but also a symptomatic tumor.

So there was lymphedema in the affected limb, plus it was just painful in the groin.

Um, we wanted to try and optimize both definitive local therapy but also palliation.

So the, strictly speaking, we prescribed 55 gray in 25 fractions to the tumor, so kind of following, like, an Embrace 2 paradigm if you're thinking of, like, cervical cancer or just how you would boost nodes for endometrial cancer.

But zooming out a little, when I was actually talking to the patient, I said, "Look, we want to try and help you feel better.

I think there is an approach that we can do that's totally reasonable." And I had a similar difficult case in training where what we offered was a hemipelvic approach 'cause that's-- it was only unilateral adenopathy.

And also, since it was not a metastatic disease, if it really is arising locally within a lymph node, it really showed the therapies like radio-definitive, definitive radiotherapy can really be reasonable and help, especially for cases like this where a patient is too frail for surgery or chemotherapy.