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In what head and neck subsites, if any, would you recommend adjuvant radiation s/p high quality neck dissection if pN1 disease (single ipsilateral LN <3cm) was the only risk factor?

Can the ASCO guidelines for oral cavity be applied to other head/neck subsites? NCCN, ASTRO, and ASCO guidelines vary widely and depends on the primary site. --ASCO: No adjuvant radiation in oral cavity pN1 s/p high quality neck dissection --NCCN: Consider adjuvant radiation for pN1 oral cavity, supraglottic larynx, and cutaneous SCC --NCCN: Does not recommend adjuvant radiation for oropharynx, hypopharynx, glottic larynx pN1 --ASTRO: Conditional recommendation for adjuvant recommendation for pN1 oropharynx. --ASTRO: Does not recommend adjuvant radiation for pN1 cutaneous SCC
2 Answers
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Radiation Oncology · David Geffen School of Medicine at UCLA
Answered on

The societal guidelines are all over the place. I will consider PORT in pN1 patients without other pathological risk factors if the primary was oral cavity. Oral cavity primary is, itself, a risk factor for locoregional recurrence (Peters et al., IJROBP 1993). Various retrospective studies have sugg...

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Radiation Oncology · University of Florida
Answered on

If the node was 3-4 cm or larger where the likelihood of ENE is high and may have been missed.

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