What dose-fractionation do you use for recurrent SCC (face) that was previously multiply resected and radiated, but has a persistently positive margin after re-resection?

Especially in the setting of prior “standard” adjuvant dose and refusal of the patient to undergo more extensive surgery. Do you recommend ENI in the recurrent setting?

Answer from: Radiation Oncologist at Academic Institution

Either 64 Gy at 2 Gy per QD fraction or 64.8 Gy at 1.2 Gy bid. I would electively treat treat the nodes if not previously irradiated. If nodes were previously irradiated, I would not.

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What dose-fractionation do you use for recurrent SCC (face) that was previously multiply resected and radiated, but has a persistently positive margin after re-resection?

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