What maximum dose would you allow to the orbit in the setting of adjuvant radiation therapy for an excised squamous cell carcinoma of the cheek with orbital bony infiltration and positive margin?

I am also generally aggressive in this scenario given the high risk of local and perineural failures. If the location is the infra-orbital cheek and there is any microscopic PNI, I would cover the ipsilateral V2 to FR. If there is clinical PNI, I trace the nerve back to Meckel’s cave.

For V2 tracin...

My concern in this case is lack of knowledge regarding the extent of the residual microscopic disease (with likely PNI in this aggressive skin sqcca), the high risk of non-resectable local recurrence even after adjuvant RT at this time, and the high risk of damage to the retina and optic nerve by ad...