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Topics:
Head and Neck Cancers • Radiation Oncology
What dose are you routinely using for adjuvant RT for intermediate risk p16+ SCC of the OPX s/p TORS?
For patients who fall into the E3311 intermediate risk category s/p TORS, do you routinely treat to 50 Gy? Or do you continue to treat to 60 Gy?
Answer from: Radiation Oncologist at Academic Institution
It's still just a phase II trial. Even the authors state in the introduction that their primary objectives were to demonstrate the feasibility of a prospective multi-institutional study of TOS for HPV+ OPC followed by risk-adjusted adjuvant therapy and that a planned phase III trial is in developmen...
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Answer from: Radiation Oncologist at Academic Institution
I think this question exemplifies the problem with dose de-escalation, as the question asks what dose, but doesn't specify to what. ECOG 3311 gave 50 Gy to a larger volume and then randomized a 10 gy yes/no boost. So both 50 and 60 Gy are the correct standards of care.Most 'intermediate risk' TOR pa...
Answer from: Radiation Oncologist at Academic Institution
60 Gy/30 fractions.
Answer from: Radiation Oncologist at Community Practice
60 Gy high-risk post-op site/54 Gy low-risk neck in 30 Fx with SIB technique, until we have quality phase III data as mentioned above. For some appropriately selected patients, we can get away with unilateral neck treatment. I would love to have phase III justification for reducing my doses for this...