Topics:
Head and Neck Cancers • Radiation Oncology
When is the coverage of tracheostomy site required for Head & Neck cancer radiation therapy and to what dose?
How does it vary based on disease site, lymphatics involvement, emergent vs. non-emergent trach etc.?
Answer from: Radiation Oncologist at Community Practice
I always take the stoma to 54-60 Gy, and boost to 66 Gy in case of any of the following:
emergent trach placement
subglottic extension
anterior soft tissue involvement (i.e., through-and-through thyroid cartilage involvement and/or actual soft tissue involvement anterior to thyroid cartilage)
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Answer from: Radiation Oncologist at Academic Institution
Agree with above indications. I would also add as indications: nodal ECE, close/positive inferior margins after total laryngectomy, and scar across the stomal site. Basically, whenever there is any doubt that tumor is uncontained in the neck (ECE, T4s w cartilage destruction) or close to t...
Answer from: Radiation Oncologist at Academic Institution
I always cover to the skin and to 60-66Gy depending on the situation (contaminated etc.). Like the old stomal boost.
Answer from: Radiation Oncologist at Academic Institution
Old textbooks, KKAng's book, Nancy Lee's book cover the uninvolved stoma to 50 Gy, if not involved.
Answer from: Radiation Oncologist at Community Practice
One should look at operative note as now surgical oncologist do excise the site of an emergent tracheostomy at the time of laryngectomy.