1. Elective Irradiation of Retropharyngeal Lymph Nodes as an Indication for Adjuvant Radiation Therapy After Transoral Surgery for Tonsil Cancer.
- Author
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Crompton DJ, Mohammadi H, Pirgousis P, Patel S, Janus J, Zhao Y, McGee LA, Patel SH, Routman DM, Ma DJ, and Holtzman AL
- Subjects
- Humans, Radiotherapy, Adjuvant methods, Carcinoma, Squamous Cell radiotherapy, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell surgery, Lymphatic Metastasis, Tonsillar Neoplasms radiotherapy, Tonsillar Neoplasms pathology, Tonsillar Neoplasms surgery, Lymph Nodes pathology
- Abstract
Treatment of squamous cell carcinoma of the tonsil involves primary radiation therapy (RT) or surgical resection. Historically, if RT was the primary or adjuvant treatment modality, most of the bilateral retropharyngeal lymph nodes (RPLNs) were treated electively with a therapeutic dose for subclinical disease, regardless of whether radiographically pathologic lymph nodes were seen on initial diagnostic imaging. De-escalation strategies include the incorporation of transoral surgery with the goal to either eliminate or reduce the dose of adjuvant RT or chemotherapy. Transoral surgery does not include elective removal of the RPLNs, and no guideline or outcome paper recommends adjuvant RT specifically to electively treat RPLNs. In this Topic Discussion, we discuss pertinent literature and suggest management decisions. The management decisions discussed in this Topic Discussion pertain to only tonsillar primaries and not those of the soft palate or base of the tongue., Competing Interests: Disclosures None., (Copyright © 2024 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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