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?

Topics: Head and Neck Cancers • Radiation Oncology

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

Answer from: Radiation Oncologist at Academic Institution

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...

Comments

Radiation Oncologist
Thanks! For those OC with pN1, are you treating bi...

Radiation Oncologist at David Geffen School of Medicine at UCLA
Sorry, I didn't see your question earlier (I did n...

Answer from: Radiation Oncologist at Academic Institution

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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