Topics:
Head and Neck Cancers • Radiation Oncology
In what situations, if any, would you add chemotherapy to adjuvant radiotherapy in patients with resected head and neck cancer without ENE or positive magrin?
Would a combination of other adverse features such as PNI, GIII, close margin, multiple positive nodes, T4 disease and others make you recommend chemoradiation rather than radiation alone?
Answer from: Radiation Oncologist at Community Practice
I would only consider adding Chemotherapy to radiation if at least 3 intermediate risk factors (as mentioned in the question) are present post-operatively in an HPV negative patient. Obviously, each such patient is discussed in the tumor board prior to such recommendation.
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Answer from: Radiation Oncologist at Academic Institution
In our multi-D tumor board, we do not routinely recommend concurrent radiation and chemotherapy in the post-op situation for patients who do not have positive margins or ENE.
Rarely, if we encounter patients with large or multiple level 4 nodes, we may have a discussion about the addition of chemo....