Would you offer radiation therapy to a NF-1 patient with a painful and unresectable neurofibroma of the head and neck?

I assume this is a plexiform neurofibroma and its nerve related pain along the upper T or C-spine nerve roots?

I would avoid radiotherapy if possible and instead work with your oncologist to evaluate whether the patient is a candidate for something like selumetinib if the lesion is progressive as there was evidence that selumetinib could aid tumor related pain (PMID: 28029918). Radiotherapy has been associated with a higher risk of transformation to an MPNST and so I would prefer other means of t...