cT2N0 Subglottic larynx

[RadOnc2013]

What treatment volumes/lymh node levels/fractionation would you recommend for intact cT2N0M0 SCC of the subglottic larynx? Assume the lesion is T2 due to impaired vocal cord mobility. Would you recommendations change if it was T1? T3? Would you recommend any concurrent systemic therapy?

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[thecarbonionangle]

Subglottic involvement would treat bilateral nodes (ii-iv, can spare some of II like 2a, maybe spare II all together), even if T1. +\- chemo. Could go either way. I think some “T2”s sometimes u just have a bad feeling, feel stronger about chemo then

 

[PointA]

Always treat level VI for subglottic extension.

 

[evilbooyaa]

II-IV, VI bilaterally. Easily curative case, I'm not screwing around with it trying to spare certain lymph node levels. T2N0 no systemic therapy for me. 66 to gross and 54 to microsopic in 30 fractions should be plenty.