ECT STUDY High-grade or Initially Invasive Vulva - GinOnc-ECT Study

Inclusion Criteria: * Histological diagnosis of de novo or recurrent vulvar VIN 2-3, microinvasive vulvar carcinoma in situ, and non-invasive vulvar Paget's disease * Positivity for high-risk cervical and/or vaginal HPV * Age \> 18 years * Karnofsky performance status \>70% * Informed consent to participate in the study * No surgical treatment indication due to disease extension, patient refusal, anesthesiological or reconstructive reasons * Negative Beta-hCG measurement in urine (pregnancy test or urinary beta-HCG) or in blood (plasma beta-HCG) Exclusion Criteria: * Patients with a histological diagnosis of adenocarcinoma * Patients with concomitant and/or previous tumors * Current pregnancy and breastfeeding * Chronic renal insufficiency * Chronic renal dysfunction * Patients with a cardiac pacemaker * Epilepsy * Lung diseases with moderate/severe respiratory insufficiency * Poor lung function or abnormal lung function * Significant coagulation disorders * Coagulation abnormalities (platelets \< 70,000/mm³ and INR \> 1.5) * Ongoing HPV vaccination * Patients with immunosuppressive conditions or treatments (HIV positive) * Allergy to Bleomycin and/or Cisplatin * Cumulative doses of 250 mg/m² of Bleomycin received