chapter 29 -treatment considerations Flashcards
Please use brainscape flashcards and outline 589-590 by writing questions in this deck
What is the result of altered H&N fraction schedules?
improved tumor control although an increase in morbidity.
Why is it necessary to boost scar tissue?
Tumor cells trapped in surgical scars are believed to be less oxygenated, therefore they are more radioresistant and they need more dose to be eradicated.
The treatment for cancers that have invaded bone is
Surgery, because curative RT has a high risk of necrosis.
Small lesions with negative nodes are treated with how many modalitites?
1 modality, radation or surgery.
Small lesions with positive nodes may need which treatments?
May need surgery AND radiation.
Large primary (T3/T4) lesions or extensive cervical node disease, or both usually need which treatment modalities?
Radiation, chemotherapy, and surgery.
What is the standard tx fractionation for SCC’s of H&N cancers?
200cGy/day x5 per week
What form of chemo has produced the highest remission in nasopharyngeal cancers?
Cisplatin containing combinations
What nodes do structures in the Larynx drain to?
peritracheal, lower cervical, cervical submental and sub axillary
What nodes do structures in the sinuses drain to?
Retropharyngeal & pharyngeal
What nodes do structures in the nasopharynx drain to?
Superior jugular & posterior cervical nodes
What nodes do structures in the oropharynx drain to?
Retropharyngeal, pharyngeal, submaxillary, lower cervical and jugulodigastric nodes
What nodes do structures in the oral cavity drain to?
Upper jugular, facial, submental & jugulodigastric nodes
Why is it rare to perform hyper fractionations in radiation therapy on H&N cases?
This can cause sever toxic effects such as prolonged mucosal healing time and higher incidences of morbidity
What type of surgery modalities are considered curative treatments for H&N Cancers?
Laser therapy, Cryotherapy & Electrocautery
