For very large locally advanced head and neck primary malignancies (namely SCCa), how do you decide between adaptive re-planning of a VMAT/IMRT plan during chemo-RT as option instead of induction chemotherapy?
Answer from: Radiation Oncologist at Academic Institution
Like Dr. @Caudell nicely noted, there is no survival benefit associated with induction outside of unique circumstances (such as NPC), so we would not routinely use it. Where induction could be helpful over adaptive VMAT/IMRT CRT, in our practice, are in circumstances for locally advanced HPV+ O...
Comments
Radiation Oncologist at Moffitt Cancer Center Factoring in the toxicity of chemotherapy is a key...
Radiation Oncologist at University of Missouri at Columbia, Ellis Fischel Cancer Cener I agree about the toxicity. Induction chemotherapy...
Radiation Oncologist at Mayo Clinic Agree with both comments which is why we don&rsquo...
Answer from: Radiation Oncologist at Community Practice
Sometimes we don’t have a choice and the chemotherapist dictates induction.
But, if we have a choice, we should push for concurrent CRT and use a gestalt to decide when to replan - if PTV going outside the skin, high dose lines crossing into OARs, OARs shifting into the high dose area, large ...
Factoring in the toxicity of chemotherapy is a key...
I agree about the toxicity. Induction chemotherapy...
Agree with both comments which is why we don&rsquo...