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In which situations can you spare the contralateral neck for oropharyngeal carcinoma?

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In what situation(s) would you omit contralateral neck radiation for a well-lateralized tonsilar squamous carcinoma? (Choose all that apply)

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4 Answers
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Radiation Oncology · University of Texas MD Anderson Cancer Center
Answered on

The controversy on contralateral neck disease is whether this is impacted by efferent lymphatics from the primary or collateral flow in the neck from involved nodes.

Thus with regards to the primary tonsil cancers that are T1,T2 well lateralized without involvement of the base of tongue nor soft pala...

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Radiation Oncology · UCSF Medical Center
Answered on

T1-T2 N0-N1 tonsil with less than 1 cm soft palate or base of tongue invasion. Perhaps you could use this thought process to say, very lateralized base of tongue tumor but there is really no evidence for this, other than emerging retrospective TORS series where these are being treated with ipsilater...

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Radiation Oncology · University of Michigan
Answered on

The classical report showing the safety of unilateral RT of OPC was by Brian O'Sullivan, demonstrating lack of contralateral recurrences in patients with early OPC. They used ipsilateral wedge-pair photons causing significant contralateral neck exit doses, in an era when non-HPV, smoking-related OPC...

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Radiation Oncology · The Oregon Clinic-Radiation Oncology West
Answered on · Updated on

For HPV+ pT1-2 N2a patients who are otherwise eligible for unilateral radiotherapy, does the presence of either microscopic extranodal extension (<=2 mm) or larger nodal size (e.g., >4 cm) impact your decision making about offering unilateral radiotherapy?

From my review of literature the rate of c...

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