Would you recommend concurrent chemotherapy for a T1N1 oropharynx cancer if the patient underwent excisional biopsy of the node and was found to have ECE?
How would you use the information regarding extent of ECE? What if the patient was HPV negative? What is the impact of systemic therapy on metastatic relapse when there is excellent chance of local control with radiation alone?
Answer from: Radiation Oncologist at Community Practice
Let's look at it this way. If he had surgery with neck dissection and had pT1,N1 with ECE, one would recommend concurrent chemoRT post-op. Both the EORTC and RTOG trials included this subgroup of patients. The subset analysis of the long term follow up of RTOG 9501 showed increased local control and...