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.)
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Memorial Sloan Kettering Cancer Center
Answered on
For now, always CCRT post op for ECE.
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Mednet MemberInvited Expert
Radiation Oncology · University of Florida
Answered on
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...
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