Is there a scenario in which you would consider observation for T4a SCC involving the mandible?  

While PORT is well established, the scientific basis for it is relatively weak in the absence of a randomized trial, as all phase 3 trials have focused on adding something to radiation rather than the benefit of radiation alone. Further, the rationale for PORT historically is if there is a belief o...

My standard recommendation for a pT4a squamous cell carcinoma of the mandible would be adjuvant RT. As with every patient, I would have a risk/benefit discussion with the patient, and it is always the patient's decision, but my formal recommendation for pT4a disease is adjuvant RT. The only scenario...

Here's an NCDB paper that somewhat addresses the question by Harley et al., PMID 38300601.This shows that the size of the T4a lesion matters. Perhaps there is a rationale for omitting PORT in patients with small (<2 cm) tumors.I think the big picture is yes, I would recommend PORT. But in patient...