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Head and Neck Cancers • Radiation Oncology
In patients who are HPV postive, and non-smokers who have a complete PET response to induction TPF at the primary site, would you still treat the primary site to full dose?
Do you treat the enlarged PET negative nodes to the high risk dose as well?
Answer from: Radiation Oncologist at Community Practice
Descalating therapy in HPV+ H&N SCC is the subject of investigation in ongoing clinical trials. Some are investigating de-escalation through the systemic agent used concurrently with RT (cetuximab vs cisplatin), such as RTOG 1016. Others are looking into the reduction of RT dose base...
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Answer from: Radiation Oncologist at Academic Institution
I agree with @Kiwhoon Lee. After induction chemo, I would recommend treating the primary and initially involved lymph nodes to 70 Gy regardless of response to chemo. There are several on-going studies and prelim data evaluating the possibility of reducing dose after induction chemo, but ...