Topics:
Head and Neck Cancers • Radiation Oncology
How do you treat a large, resected ex pleomorphic adenoma with unknown margin status due to tumor fragmentation?
Would you observe or radiate?
What volume, dose, fractionation would you use?
Systemic therapy?
Answer from: Radiation Oncologist at Academic Institution
Treat the tumor bed to 60-66Gy, no systemic therapy needed.
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Answer from: Radiation Oncologist at Academic Institution
Follow and, if it recurs, resect and irradiate. Tumor spillage does not increase the risk of local recurrence for PA.
Answer from: Radiation Oncologist at Academic Institution
If the path is carcinoma ex pleo, would certainly offer PORT. Usually, a spill/tumor fragmentation does merit PORT consideration.
Spills involving the deep lobe are harder to salvage without impacting the nerve.
If it's a recurrent pleo w/o ca, it comes down to how confidently a salvage resec...
Answer from: Radiation Oncologist at Academic Institution
I agree that if carcinoma ex PA add postop RT.