How would you treat a postoperative pT4a NX larynx who had TL without node dissection and no suspicious nodes on pre-surgical imaging, specifying nodal volume and dose levels?

Are there elective neck regions you would choose treat to high risk (ie. 60 Gy) instead of low risk (ie 54Gy) dose?

Are there risk favors that would sway you one way or the other such as LVI?

Answer from: Radiation Oncologist at Academic Institution

Laryngeal T4a may consist of different entities with different LN involvement risks. If it involves the supraglottic larynx, it requires RT to levels II-IV bilaterally. If it is transglottic and extends to the subglottic larynx, include also level VI. If it is confined to the glottic larynx and the ...

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Radiation Oncologist at UTMB
I would also offer localized RT for T4a of the glo...

Answer from: Radiation Oncologist at Academic Institution

Levels 2, 3, 4, 6 bilaterally to 50 Gy/25 fractions or equivalent, and 60 Gy/30 fractions if margins negative to primary site (base of tongue, neopharynx, and stoma).

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Radiation Oncologist at Jacob E Locke MD PA
What if your patient had a T2N0 supraglottic, -PNI...

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How would you treat a postoperative pT4a NX larynx who had TL without node dissection and no suspicious nodes on pre-surgical imaging, specifying nodal volume and dose levels?

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