Topics:
Head and Neck Cancers • Radiation Oncology
In what N1 H&N patients, if any, would you consider treating the gross disease (primary + involved node) only without elective nodal radiation volume with definitive intent in order to reduce toxicity?
Can elective nodal RT be omitted for select patients with T2-4N1 head and neck cancers with multiple commodities and poor KPS with life expectancy <3 yrs who are not candidates for chemo based on the rationale that the toxicity may outweigh any benefit?
Answer from: Radiation Oncologist at Academic Institution
Madness. Not just no but bleep no. I don’t want to injure a lot of patients and discover something stupid.
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Answer from: Radiation Oncologist at Academic Institution
Generally, we try to give patients the benefit of doubt and treat locally advanced disease with curative intent therapy. If one is uncomfortable with de-escalated elective volumes (we use 30 Gy for HPV-positive and 40 Gy for HPV-negative non-oral cavity disease), then this would be a reasonable situ...