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How would you utilize adjuvant radiation therapy in a patient with a cutaneous spindle cell neoplasm of the scalp metastatic to the parotid gland?
What dose-fractionation schedule and treatment volumes would you utilize for adjuvant radiation therapy status-post total parotidectomy with negative margins? In a patient that had a previously resected cutaneous spindle cell neoplasm of the skin via Mohs surgery, would you include the original site of disease within your treatment volumes? Would you electively cover cervical lymph nodes?
Answer from: Radiation Oncologist at Academic Institution
A lot will depend upon how “total” the parotidectomy really was. If the deep lobe was resected and the facial nerve sacrificed with totally negative margins I would be content to utilize careful observation with no postoperative radiation therapy to the parotid bed. If only a...
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