Would you ever NOT recommend adding concurrent chemotherapy to adjuvant radiation in +ECE oropharynx SCC patients who can tolerate it?
In the context of the new staging systems and possible differences of HPV mediated vs smoking mediated oropharynx SCC, would you ever not recommend concurrent CRT in an otherwise healthy patient without contraindications?
Does the degree of ECE matter? (microscopic vs. macroscopic etc.)
Answer from: Radiation Oncologist at Academic Institution
I do not recommend initial surgery unless there is a good chance of avoiding postoperative RT. I think that the outcomes are no better, treatment can likely be safely deintensified in HPV positive non smokers, and many patients probably undergo an unnecessary neck dissection that could have been avo...
Agree with @Nancy Y. Lee