How would you treat patients with advanced head and neck cancer with involvement of upper mediastinal lymph nodes?  

Depends on the extent and condition of the patient. For a healthy patient, limited upper mediastinum, I’d treat aggressively with chemoRT.

I agree with Dr. @William M. Mendenhall. We try to treat volumes that include a significant margin of nodal territory distal to the lowest involved nodal area. This might involve treating to the level of the carina, for example. The CT simulation should include the entire thorax to permit calculati...