For early stage indolent NHL (low grade follicular, MALT) involving midline structures of the head and neck (ie base of tongue, soft palate) how do you apply the concepts of ISRT?

For example: would you treat the entire Waldeyer's ring? For a stage II patient who also has cervical lymph node involvement on one side, do you only treat that side in addition to the extranodal site? Do you ever prophylactically cover the contralateral neck?

There are multiple examples in other questions on this forum and in the ISRT guidelines that refer to more generous coverage when chemotherapy is not used. Would this be one such situation?

Answer from: Radiation Oncologist at Academic Institution

@Kyle A. Denniston,I think your question is a good one and probably not one answerable by definitive data. However, the recent publication of the ILROG guidelines on extranodal disease (Yahalom et al, https://www.ncbi.nlm.nih.gov/pubmed/25863750) and bulk of available data I believe suggest that it&...

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For early stage indolent NHL (low grade follicular, MALT) involving midline structures of the head and neck (ie base of tongue, soft palate) how do you apply the concepts of ISRT?

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