How would you treat a postoperative pT4a NX larynx who had TL without node dissection and no suspicious nodes on pre-surgical imaging, specifying nodal volume and dose levels?

Laryngeal T4a may consist of different entities with different LN involvement risks. If it involves the supraglottic larynx, it requires RT to levels II-IV bilaterally. If it is transglottic and extends to the subglottic larynx, include also level VI. If it is confined to the glottic larynx and the ...

Levels 2, 3, 4, 6 bilaterally to 50 Gy/25 fractions or equivalent, and 60 Gy/30 fractions if margins negative to primary site (base of tongue, neopharynx, and stoma).