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)?  

For example, for a cN0 oral tongue cancer with I-III dissected with involved LN, pN1, would you use 54 Gy or 60 Gy for level IV? Or do you always take the entire ipsilateral neck to 60 Gy postop?

Would this change if the +LN were only in levels I-II vs also involving level III (adjacent vs. non-adjacent to the involved level)?

What other factors might affect your dose choice?

What about level V?



Answer from: Radiation Oncologist at Academic Institution
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Radiation Oncologist at Lake Huron Medical Center
They don't call it the Garden Book for nothing. Th...
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Answer from: Radiation Oncologist at Academic Institution
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Radiation Oncologist at University of Florida
54.
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Answer from: Radiation Oncologist at Academic Institution