Mednet Logo
HomeQuestion

Do you consider the undissected ipsilateral level IV neck a high or low risk nodal station after selective neck dissection of levels I-III revealed positive node(s)?

1
3 Answers
Mednet Member
Mednet Member
Radiation Oncology · University of Texas MD Anderson Cancer Center

Our general philosophy for the postoperative neck is 3 dose levels:

60 - tumor bed (+ margin),

57 - operative bed,

54 - undissected neck.

These doses are based on treatment in 30 fractions.

Naturally, though, there is the proverbial art versus science. In post op the tumor bed is virtual, often base...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Radiation Oncology · David Geffen School of Medicine at UCLA

Typically in the postoperative setting, my 60 Gy volume consists of the tumor bed and preoperative primary/nodal GTV (which has been excised), deformed to the postoperative (current) anatomy, plus an additional 5-10 mm CTV margin. (The margin size may be customized depending on uncertainties in imag...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Radiation Oncology · UT Southwestern School of Medicine

One corollary to this question is whether the "risk-level" of a clinically-negative (undissected) neck level should ever influence the dose. The probability of disease in that level (typically what is referred to as "risk") primarily determines whether it should be treated at all; of course, usually...

Register or Sign In to see full answer