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DIAGNOSIS: This is a 39 year old man with P2n2bN0 squamous cell carcinoma of left tonsil. PLAN OF THERAPY: Curative post-operative radiation therapy. DATE RADIATION STARTED: April 13, 1998 DATE RADIATION COMPLETED: May 22, 1998 FIELDS AND DOSES: The patient received a total dose of 6000 cGy to the tumor volume employing various fractionation schemes. He first received 200 cGy per day to the head and neck and supraclavicular region. The head and neck area was treated with 6MV photons in opposed lateral fields calculated to the midline and the supraclavicular area was treated with 6 MV photons calculated to a depth of 3cm in an AP field. At 4000cGy the head and neck field was continued as an off cord boost with 200 cGy delivered to the right and posterior triangles employing 2 MeV electrons calculated to the 90th percentile en face fields. The supraclavicular field was discontinued at 5000 cGy and the right posterior triangle was discontinued at 1000 cGy which combined with the previous field at 4000 cGy yielded a total dose of 5000 cGy. The left posterior triangle was discontinued at 1600 cGy which combined with the previous field of 4000 cGy yielded a total dose of 5600 cGy. The off cord boost field was treated to a total dose of 5000 cGy at 200 cGy per day. Lastly the off cord boost was continued as a final tumor-bed boost delivering 1000 cGy in 5 fractions of 200 cGy each therefore delivering a grand total dose of 6000 cGy to the tumor volume. STATUS Of TUMOR: Indeterminate TOLERANCE: Mr. Teel developed symptoms of pharyngitis during his treatment course as expected. He also developed some erythema on his skin within the treatment field. He developed some hoarseness and dry mouth during the treatment course as well. No treatment break was necessary and his symptoms were managed with medication. |