What would your radiation volume be for a patient with SCC just medial to the infraorbital foramen with positive PNI who presented with pain s/p regional excision?

Probably operative bed, 5-10 mm CTV into soft tissues, and the path of the V2 cranial nerve.

I would get an MR which would likely not show gross PNI. Regardless, I would treat to the skull base with protons. If protons are unavailable, 260 kVp with a lead mask exiting down the nerve if margins were negative. If 250 kVp is unavailable, electron. If positive margins and protons are unavailabl...