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Head and Neck Cancers • Radiation Oncology
Would you offer adjuvant radiotherapy to a small low grade T1 adenoid cystic carcinoma of the minor salivary gland that was completely resected?
After a wide excision for a <3mm lesion, flap reconstruction and selective neck dissection and no initial PNI, residual tumor, or positive ymph nodes?
Answer from: Radiation Oncologist at Academic Institution
I can think of one ACC patient I have not irradiated postop in over 35 years. This would be the second. 3mm? Really? 3cm I would irradiate.
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Answer from: Radiation Oncologist at Community Practice
This is not a straightforward scenario. In reality we would have performed a minimal resection of the gross tumor for this tiny tumor, followed by neutron RT that is highly effective. We do not perform neck dissections for ACC. In this case, the surgeon/patient appear determined to be managed ...