What would be your approach to the treatment of limited stage extrapulmonary small cell carcinoma of the nasopharynx with bilateral cervical lymphadenopathy?

Rare entity and not a whole lot of evidence to base treatment decisions on.

That being said, at least make sure a brain MRI has been completed (I know this seems obvious, but just in case).

If the patient was in good shape, I would treat with concurrent CRT based on a series out of Japan. Whether to ...

Agree with Dr. @Dr. First Last, esp regarding no need for PCI. Extrapulmonary tumors, including small cell, do not drain to the brain unless there are lung metastases.