Topics:
Head and Neck Cancers • Radiation Oncology
How would you manage a high grade acinic cell carcinoma of the parotid with isolated recurrence in the ipsilateral neck s/p salvage resection?
Patient previously had adjuvant radiation to the tumor bed only.
What is your radiation volume and dose?
Any elective nodal levels (ipsilateral vs. contralateral) or involved level only? Dose?
Answer from: Radiation Oncologist at Academic Institution
High grade acinic cell is practically a misnomer. At any rate, badly behaved. If really high grade at the outset, neck should have been irradiated. Now ipsilateral neck. Tempted to include the primary site. Contralateral neck low risk.
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Answer from: Radiation Oncologist at Academic Institution
For this patient with a neck recurrence and (presumably) no evidence of primary site recurrence who had been treated with RT previously to the parotid bed, I would treat ipsilateral neck levels IB, II, III, IV, and V. While IB coverage may be controversial, if the recurrence was in level II, I would...