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?
Are there elective neck regions you would choose treat to high risk (ie. 60 Gy) instead of low risk (ie 54Gy) dose?
Are there risk favors that would sway you one way or the other such as LVI?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · University of Michigan
Answered on
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 ...
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Mednet MemberInvited Expert
Radiation Oncology · University of Florida
Answered on
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).
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