What is your approach to definitive radiation for p16+, cT2N1M0 (AJCC 8th ed) base of tongue SCC?
Definitive RT only?
Concurrent chemo-RT?
Technique, dose (for radiation and chemo, if any), fractionation?
Answer from: Radiation Oncologist at Academic Institution
If there are multiple ipsilateral LNs, then I recommend CCRT with cisplatin. 70 Gy in 35 fractions via IMRT/VMAT. If only a single LN, I would likely recommend the same (especially if a large LN) if the patient could tolerate it, though RT alone is reasonable. If RT alone, then I typically accelerat...
Answer from: Radiation Oncologist at Academic Institution
Offering RT alone for T2N1 OPhx in the 7th edition was controversial in and of itself. Unfortunately, for H&N we still have to 'convert' all 8th edition staging back to 7th edition to determine eligibility for trials and define treatment paradigms. Current N1 includes multiple patients that woul...
Answer from: Radiation Oncologist at Academic Institution
At this time, when the Corona epidemic justifies reduced interactions with patients as much as possible, for T1-2/N0-1 OPC I would recommend the approach of RTOG 0022 (Eisbruch et al., PMID 19540060): accelerated hypofractionation, 66 Gy in 30 fractions daily over 6 weeks. It delivered tumor BED2 of...