Stage IA MALT of Base Of Tongue

[Mandelin Rain]

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What do you treat for ISRT? I'm thinking of going 30 Gy.

 

[xrthopeful]

24Gy/12 fx or don't come at all

 

[Mandelin Rain]

Dose notwithstanding, what do you treat for ISRT? Whole of Waldeyer's Ring? Avid Disease + margin? The consensus ISRT papers are essentially worthless for these types of questions.

 

[Irradi8or]

Dose notwithstanding, what do you treat for ISRT? Whole of Waldeyer's Ring? Avid Disease + margin? The consensus ISRT papers are essentially worthless for these types of questions.

Actually, if you take another look at the ILROG consensus guideline on extranodal lymphomas (Yahalom et al Int J Radiat Oncol Biol Phys. 2015 May 1;92(1):11-31), they do suggest an answer...

Volume CTV is determined by the prechemotherapy GTV, but often the entire involved structure (eg the whole tonsillar fossa from the level of the soft palate to the level of the vallecula) is included (Fig. 4) because of uncertainty about the exact extent of initial involvement. Uninvolved structures are not included in the CTV, and neck nodes are treated only if involved. PTV margin depends on immobilization; with optimal fixation it is normally 4 to 5 mm.

 

[Palex80]

Exactly! Use the ILROG guidelines!

 

[Damn_Daniel]

24 to involved area plus a margin to account for adjacent tissue/structures sounds extremely reasonable