How would you approach a locally advanced, node positive oral cavity squamous cell carcinoma of the H&N with cCR after induction chemotherapy?
Is surgery still indicated? If no surgery is pursued, (how) would you deliver consolidative radiation therapy?
Answer from: Radiation Oncologist at Academic Institution
I would use consolidative full-dose chemo-RT to the pre-chemo CTVs.
I would not reduce the extent of the CTVs or treatment intensity. Before the TPF era, randomized studies of induction followed with RT vs RT alone in HNC did not result in improved outcomes in the induction arms, despite achieving ...
Answer from: Radiation Oncologist at Academic Institution
I agree with both @Avraham Eisbruch and @Farzan Siddiqui.
We advocate a 'virtual" GTV—ie a GTV based on pre chemo target definition.
Ideally in a multidisciplinary setting, a pre chemo simulation can be done to help with ultimate target delineation, but this is often difficult to arrang...
Answer from: Radiation Oncologist at Academic Institution
I completely agree with @Avraham Eisbruch's response. I am not sure why induction chemotherapy would be considered in an oral cavity cancer patient? Upfront surgical resection is the standard of care for these patients. However, even in case this was offered, for any reason, the patient should be se...