Topics:
Head and Neck Cancers • Radiation Oncology
How would you approach a small, node-negative (cT1-2N0) nasopharyngeal cancer in a patient with prior H&N cancer treated with surgery and radiation?
Do you always radiate the elective neck in addition to the primary site?
If they had one-sided neck dissection and radiation for their prior cancer, would you skip that side? If you would include, how does this change your dose/fractionation?
Answer from: Radiation Oncologist at Academic Institution
RT to primary and RP nodes. Positive nodes in previously irradiated neck likely 10% or less, so I’d observe neck.
Sign in or Register to read more
Answer from: Radiation Oncologist at Academic Institution
RT to the primary, RP nodes, and previously UNirradiated neck, but avoid re-irradiation.
At our institution, we would make sure to get old radiation records and see what dose was received to the nodes that we would typically include for a nasopharynx case and make final decisions based on that. We ...
Comments
Radiation Oncologist at Swedish Covenant Hospital (Chicago IL)
Not sure what the difference is between options 2 ...
Not sure what the difference is between options 2 ...
Answer from: Radiation Oncologist at Community Practice
This was not an option in the question stem but just to note, there is now phase III randomized data that endoscopic resection carries a significant survival benefit compared to re-irradiation. I realize this question stem is probably talking about previous RT that may not have overlapped the primar...