How would you manage a imaging suspicious undissected (ipsilateral) lymph node in the setting of post-op RT for an oral cavity cancer with extensive nodal disease and ECE?

Topics: Head and Neck Cancers • Radiation Oncology

How would you manage a clinically suspicious (CT/PET) but undissected (ie., level V or paratracheal) lymph node in the setting of post-op RT for an oral cavity cancer with extensive nodal disease and ECE?

Would you treat to pre-op gross disease doses (ie., 70 Gy/35 fractions), or 63-66 Gy and keep typical post-op fractionation?

Answer from: Radiation Oncologist at Academic Institution

Chemo RT, 70 Gy to the node, followed by PET CT in 3 months.

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