What do you consider negative or close margins for tonsillar cancers?

To answer your first question about margin for HPV+ (I assume) tonsillar cancers, one would have to go with the definition on clinical trial. Currently the WashU trial as well as RTOG 1221/ECOG 3311 and the ADEPT trial uses the 3mm cutoff. So a free margin is defined as something>/=3mm. Anything <3mm is considered "close margin."

To answer your second question, particularly on the use of chemo, one would really need more info.

Is this again HPV+ve disease? How about smoking history? Alcohol? What nodal levels were involved and how many nodes? What is the T and N stage? Is ECE present?

Is the question about treatment de-intensification?

While I appreciate the need to want to de-escalate, I would not recommend doing so off trial and would str...

I won't use chemo for close margins for tonsilar cancers, particularly if it's HPV positive cancer.