- Shuffle
Toggle OnToggle Off
- Alphabetize
Toggle OnToggle Off
- Front First
Toggle OnToggle Off
- Both Sides
Toggle OnToggle Off
Front
How to study your flashcards.
Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key
Up/Down arrow keys: Flip the card between the front and back.down keyup key
H key: Show hint (3rd side).h key
PLAY BUTTON
PLAY BUTTON
24 Cards in this Set
- Front
- Back
|
What is the incidence of second primary cancers for patients with a history of squamous cell cancer of the head and neck?
|
3-7% annually, particularly for other sites including lung, esophagus (and head/neck)
|
|
What is the difference between synchronous and metachronous head and neck cancers?
|
Synchronous occur within 6 months, metachronous more than 6 months apart.
|
|
What percentage of head and neck cancers are localized at the time of diagnosis?
|
90%
|
|
What are the four criteria for unresectability in head and neck cancer?
|
-base of skull involvement
-fixation to the prevertebral fascia -carotid encasement -pterygoid musculature |
|
When is PET-CT indicated in the workup of head and neck cancer?
|
For patients with nasopharyngeal cancer with lymph node involvement, for whom the incidence of distant mets is 60%. Bone is the most common site.
PET can also be useful: -when the primary is unknown -to identify regional node involvement in the N0 neck -in post treatment assessment |
|
A 52 year old man with a long history of tobacco and alcohol abuse presents with hoarseness. Workup reveals a 1.5 cm primary squamous cell tumor of the larnyx, with one pathologic ipsilateral node 3 cm in diameter. How should he be managed?
|
Chance of cure is good with either radiation or surgery.
|
|
What are the treatment options for head and neck cancer patients with high-volume stage III or stage IV (no distant mets) disease?
|
If resectable, surgery and adjuvant radiation +/- chemo (based on risk factors). Concurrent chemoradiation can also be used for organ preservation. Surgery, in this case, can be used for salvage.
|
|
Which three structures are not spared in a radical neck dissection?
|
-internal jugular
-SCM muscle -spinal accessory nerve |
|
What is the timing of radiation therapy after surgery for head and neck cancer?
|
4-6 weeks.
|
|
What are the pros and cons of altered fractionation schedules for head and neck cancer?
|
Improves local control at the cost of increased acute toxicity.
|
|
What is the standard of car for head and neck cancer patients with positive resection margins or extracapsular extension?
|
Concurrent cisplatin and radiation.
|
|
A 48 year old woman has locally advanced but resectable cancer of the larynx, and she is interested in preservation of the larynx. How should she be counselled?
|
Her options include radiation only or concurrent chemoradiation; survival is the same but the chance of needing salvage surgery is twice as high if she gets radiation alone.
|
|
How are locally advanced (T3, T4 or N2, N3) cancers of the oropharynx treated?
|
With concurrent chemoradiation, to preserve speech and swallowing function.
|
|
How is management of locally advanced cancer of the hypopharynx different from management of locally advanced cancer of the larynx?
|
Induction chemoradiation is used for locally advanced hypopharyxnx cancers.
|
|
What is the standard of care for locally advanced unresectable head and neck cancer?
|
Radiation with concurrent high-dose cisplatin
|
|
What is the role for cetuximab (Erbitux) with radiotherapy in the treatment of head and neck cancer patients with advanced disease?
|
Indicated for use in patients in whom age, performance status and/or comorbid condition preclude the use of cisplatin or carboplatin.
|
|
What chemotherapy regimen is appropriate for patients with locally advanced cancers of the hypopharynx?
|
Induction chemotherapy with cisplatin + 5-FU or docetaxel, cisplatin and 5-FU
|
|
For nasopharyngeal cancer, how does WHO type affect response to chemotherapy and radiation?
|
WHO type I is squamous cell cancer.
WHO types II and III are more response to chemo and radiation. |
|
What is the standard treatment for stage I or IIa nasopharyngeal cancer?
|
Radiotherapy alone.
|
|
What is the standard of care for stage IIb-IVb nasopharyngeal cancer?
|
concurrent cisplatin and radiotherapy followed by three cycles of adjuvant cisplatin + 5-FU
|
|
What therapy is used for metastatic or recurrent head and neck cancer?
|
If the patient can tolerate it and a significant amount of time has elapsed if they were previously treated, cisplatin and 5-FU with or without cetuximab is appropriate.
|
|
What is the historical gold standard single agent treatment for incurable recurrent or metastatic head and neck cancer?
|
Weekly methotrexate.
|
|
What is the indication for single-agent cetuximab in head and neck cancer?
|
Approved for use in platinum-refactory disease.
|
|
Which small molecule TKI inhibitor has activity in the setting of incurable recurrent/metastatic head and neck cancer?
|
erlotinib (Tarceva) has modest activity (~4% major response rate, ~50% disease stabilization). Avastin added to Tarceva bumped response rate to 17% and OS to 7.5 months in one study.
|
