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Head and Neck Cancers • Radiation Oncology
To what dose do you treat enlarged, but PET negative lymph nodes in laryngeal SCC?
For a T3N0 SCC of the larynx with PET/CT showing negative cervical nodes, but with CT neck showing a 1.5cm level II cervical node, to what dose to you treat the enlarged node and adjacent nodal levels if the patient is unable to undergo biopsy of the cervical node in a timely fashion?
Answer from: Radiation Oncologist at Academic Institution
If a node meets criteria for involvement by physical examination (firm, stuck to surrounding structures), or CT (enhancing, loss of fatty hilum, rounded), I give the node (+ 3mm for PTV) 70 Gy in 35 fx. Level II would also be a first-echelon node, raising my suspicion. The remaining level II re...
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