How high have you guys gone? Have a lady who presented with about a 7cm neck mass, initially responded to chemo but over final 2 cycles exploded to a 12+ cm mass. Not a candidate for any further chemotherapy, transplant, etc. Has been under external beam with me and has completed about 45 Gy already And only this week have I begun to see some shrinkage of tumor. I see recommendations suggesting treating these up to 55 Gy but I'm thinking that might not be enough. thoughts? She is tolerating treatment extremely well for what it's worth