Tonsillar CA

[CUBuffsgrad98]

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In a post excisional bx of the tonsil with positive margins (no "gross" disease) do you treat as post op, or target the area to 70 Gy?

 

[Neuronix]

I was trained to treat a tonsillectomy/excisional biopsy with positive margins the same way I would treat a smaller volume biopsy for tonsillar cancer. Assume gross disease, examine and use your imaging as best possible to determine a 70 Gy volume with concurrent chemo.

 

[CUBuffsgrad98]

So what do you target with 70 Gy? no PET until after resected (PET neg, but a lot of positive margins). Difficult to visualize a tumor "bed"......