How do you approach dosing for post-op HNSCC nodal regions with ECE?
Do you modify your dose based on p16 or extent of ECE (e.g. microscopic vs macroscopic)?
4 Answers
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Radiation Oncology · University of Wisconsin School of Medicine and Public Health
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This is an area in which the communication between surgeon, pathologist, radiologist, and radiation oncologist is particularly helpful. While our surgeons try to submit nodes with descriptive identification of the nodal level they arise from, it still occasionally happens that we see a pathology rep...
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Radiation Oncology · Memorial Sloan Kettering Cancer Center
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I think 60 in 2 is enough with chemo.
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Radiation Oncology · Medical University of South Carolina (Charleston)
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60 Gy for p16 positive
66 Gy for p16 negative
I do not factor in extent of ENE
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Radiation Oncology · University of Missouri at Columbia, Ellis Fischel Cancer Cener
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A very good question. For high risk areas at least 60Gy (and up to 66 Gy) with chemotherapy which was the experimental arm in the RTOG/EORTC combined series, and most protocols have used that dose range. https://www.ncbi.nlm.nih.gov/pubmed/16161069?dopt=Abstract I have used 64-66 Gy for ENE and 66 G...
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