H&N Flashcards
T staging for Nasopx Ca
t1 - confined to naso or extension to oro or nasal cavity
t2 - spread to parapharyngeal space or surrounding soft tissues
t3 - spread to bony structures of skull base
t4 - intracranial involvement
who path staging nasopx ca
WHO type 1 - keratinizing
2 - non-keratinizing
3 - undifferentiated
Nasopx
What are the SIB volumes and what do they include?
GTV - gross disease + involved LNs
ctv70 - high risk, ctv + 5mm
ctv60 - interm. risk, ctv70 + microscopic involvement
ctv54 - retropharyngeal nodes
PTVs - 3-5mm margins
nodes often involved and where they are located for nasopx ca
retropharyngeal nodes
fossa of rossenmuller
most common pathology of paranasal sinus ca
SCC
what nodes are often included in paranasal sinus ca
submandibular - first station to be involved
then ipsilateral jugulodigastric/subdigastric
TV doses for paranasal sinus
GTV 66-70Gy
CTV1 (margin of normal tissue) 59-63
CTV2 (rest of involved sinus plus nerves and elective nodes) 54-57
Oropx
most common site?
most common site of mets?
most common distant mets?
tonsillar fossa
ipsilateral level 2 LNs
lungs
oropx
most common clinical presentation
sore throat and odynophagia
Oropx
disease management?
T1-2 with no N definitive radiation
T3-4 no N ChemoRT OR surgery
- This goes for any N as well
6000-6600-7000 with 200 per day
3000-5000 preop
Hypopx
most common site?
most common LNs involved?
most common distant mets?
priyafrom sinus
level 2 and 3
lung
Hypopx
most common clinical presentation
painful swallowing
Hypopx
disease management?
Definitive RT for stage T1-2 with no nodal mets
Concurrent chemoRT for N0-N2a or positive surgical margins
Induction chemo for those at risk of distant mets
glottic staging
T1 glottic disease: a-one cord; b-both cords
T2 spreads to supra/sub glottic with impaired mobility
T3 fixation limited to the larynx OR invasion to paraglottic space
T4 a-locally advanced disease; b-very advanced (invades prevertebral space or mediastinum or encases carotid
