Interesting H & N case
Here's an interesting case
65 year old patient, heavy smoker.
Had a partial laryngectomy and ipsilateral (right) neck dissection in 2019 for a pT1 pN0 (0/20) G3 SCC in the right supraglottic area. Clear margins, no adjuvant treatment.
A suspicious lymph node was palpated in the left neck (level II) during follow-up, biopsy showed SCC, p16 negative.
PET showed no other uptake, endoscopy showed no recurrence in the larynx or some other primary tumor.
He received a bilateral tonsillectomy and...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - May 28, 2021 Category: Universities & Medical Training Authors: Palex80 Tags: Radiation Oncology Source Type: forums
T4a Larynx cancer with negative nodal dissection no concerning pathologic features...
s/p total laryngectomy with negative unilateral neck dissection, some invasion into the contralateral larynx and erosion through thyroid cartilage. ENT not concerned about stomal margins etc. No PNI, no LVSI. Referred him to me because that's what we do, and T4 tumors don't present this way commonly enough to really say much about forgoing adjuvant RT as far as I can tell, though the NCCN seems to allow for observation in a similar setting. Main problem in the present case is no...
T4a Larynx cancer with negative nodal dissection no concerning pathologic features... (Source: Student Doctor Network)
Source: Student Doctor Network - September 23, 2020 Category: Universities & Medical Training Authors: Ray D. Ayshun Tags: Radiation Oncology Source Type: forums
pT4N0 larynx - post op radiation volume
I have a patient s/p total laryngectomy and bilateral neck dissection (0/19 on one side, 0/23 nodes on the other side). Path showed a ~4 cm tumor, extension through cartilage into soft tissues. Margins negative.
I'm planning post op radiation; classically the neck/nodes would have been treated, but I'm thinking no specific targeting of his nodes (ie just treat his operative bed to 60 Gy).
Any thoughts here? One of my head/neck attendings would have definitely covered nodes, and...
pT4N0 larynx - post op radiation volume (Source: Student Doctor Network)
Source: Student Doctor Network - May 17, 2018 Category: Universities & Medical Training Authors: BobbyHeenan Source Type: forums
Reirradiation for recurrent glottic cancer
Dear collegues,
Your opinion is needed plz.
70 yo male, smoker
may 2016: radiochemotherapy for T3N1 supraglottic squamous cell carcinoma
He received 70Gy in 35 fractions to the GTV,60Gy to the intermediate risk regions and 50 Gy to the low risk PTV, 3DRT +IGRT ( could not afford IMRT. In my country VMAT is not covered)
He kept smoking and drinking
Good response to CRT
March 2017: he relapsed with 2cm transglottic lesion and underwent total laryngectomy with bilateral neck dissection...
Reirradiation for recurrent glottic cancer (Source: Student Doctor Network)
Source: Student Doctor Network - May 16, 2017 Category: Universities & Medical Training Authors: Kroll2013 Source Type: forums
