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Head and Neck Cancers • Radiation Oncology
In what situations, if any, is it appropriate to forego surgery for nodal recurrence (intraparotid and/or ipsilateral neck) of cutaneous SCC and definitively treat with chemo-RT?
Assuming patient is medically operable, would you always advocate for surgical dissection? If so, how to you approach post op radiation (and chemo).
If you would omit surgery, what radiation dose/fractionation/volume do you use? Concurrent or adjuvant systemic therapy?
Answer from: Radiation Oncologist at Academic Institution
I would consider definitive chemoradiation therapy if a patient was medically inoperable or the cancer was surgically unresectable. Otherwise, I would advocate for therapeutic lymphadenectomy, and usually, adjuvant radiotherapy, unless the pathologically evaluated nodal disease was low risk (only on...
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Answer from: Radiation Oncologist at Academic Institution
When a gross total resection is not possible.