How do you manage the elective lymphatics in high risk squamous cell carcinoma of the skin?

For the high risk features mentioned in the question, elective RT to draining nodes and neural pathways should be considered. The acceptable dose/fx for elective RT in SCC is generally 50 Gy in 25 fx (ranges from 45-54 Gy). <1.8-2 Gy/fx is acceptable in dose painted plans. For the nodal fields a goo...

I agree with above. 50 Gy in 25 fractions is the common fractionation scheme. See UF data. https://www.ncbi.nlm.nih.gov/pubmed/26391010

"Essentially for tumor diameter > 2 cm, tumor thickness > 5 mm, poor differentiation, tumor location within ear, age > 70 years, perineural invasion (PN...