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FRCR2 > H&N neck levels > Flashcards

H&N neck levels Flashcards

1
Q

when should contralateral neck irradiation be offered following primary surgery to an oral cavity tumour and ipsilateral neck dissection

when should it be considered

A

Offer contralateral RT if:
- T3-4 tumour (>4cm or locally invasive)
- ≥2 nodes positive in ipsilateral neck
- any ECE within the ipsilateral neck
- primary <10mm from midline

Consider if:
-single ipsilateral LN and no ECE

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2
Q

When can unilateral RT be considered for a tonsillar tumour instead of bilateral

A

T1-2N0, well lateralised tumour

T1-2 N2b (multiple ipsilateral nodes, <6cm) - if 1-2 nodes only, both <3cm and located only in levels 2 & 3

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3
Q

If level 4A or 5b is involved, what levels must also be included

A

4B & 5C

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4
Q

If level 2 nodes are involved, which levels must also be included

A

1b, 5a&b, 7b

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5
Q

What level should be included if 1b or 4 is involved

A

level 5

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6
Q

what levels should be treated for a nasopharyngeal tumour

A

2,5,7A

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7
Q

oral cavity
T1-2 N0 , >1cm lateral to the midline
What nodal levels should be treated

A

Ipsilateral:
1a-4a; 9 if buccal mucosa involved

Contralateral:
None

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8
Q

Oral cavity
T2 N1, >1cm lateral to the midline
What nodal levels should be treated

Which additional level should be included dependent on which nodal level being positive

A

Ipsilateral: 1a-4a
Contralateral: none

9 if buccal mucosa involved

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9
Q

Oral cavity
T2N0, <1cm lateral to the midline or T3N0
What nodal levels should be treated

A

Bilateral 1a-4a
9 if buccal mucosa involved

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10
Q

Oral cavity
T2N1, <1cm from midline
What levels should be included

A

1a-4a bilaterally
9 if buccal mucosa involved

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11
Q

Oropharynx
T1-2 N0, lateralised

A

Ipsilateral: 2-4a (1b if oral involvement)
Contralateral: none

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12
Q

Oropharynx
T1-2 N0, <1cm from midline

A

Ipsilateral: 2-4a (1b if oral involvement)
Contralateral: 2-4a

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13
Q

Oropharynx
Tany N1

A

Ipsilateral: 1b, 2-4a & 7A if posterior pharyngeal wall involvement
Contralateral (if <1cm to midline): 2-4a & 7A if posterior pharyngeal wall involvement

Consider unilateral treatment only if well lateralised primary
(>1cm from midline, not involving base of tongue, posterior pharyngeal wall or extension onto adjacent soft palate by >10mm)

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14
Q

Oropharynx
Tany N2a-2b (single - multiple ipsilateral nodes, <6cm)

A

Ipsilateral: 1b-4a, 5a&b, 7a&b
Contralateral: 2-4a (& 7A if posterior pharyngeal wall)

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15
Q

Oropharynx
N2c - contralateral or bilateral nodes

A

Dependent on node positivity
2-4a bilaterally at least
& 7A if posterior pharyngeal wall

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16
Q

Oropharynx
N3 - node >6cm (N3a) or ECE+ (N3b)

A

Ipsilateral: 1b-4a, 5a&b, 7a&b
Contralateral: 2-4a
7A if posterior pharyngeal wall bilaterally
+ include locally invaded structures

17
Q

Nasopharynx
What CTV
T1-2 N0

A

CTV-60: CTV-65 +5mm, whole nasopharynx, inferior sphenoid sinus
Nodes: Bilateral 2A-5A, 7A&B

18
Q

Nasopharynx
What CTV
T1-2 N+

A

CTV-60: CTV-65 +5mm, whole nasopharynx, inferior sphenoid sinus
Nodes: Bilateral 2A-5A&B, 7A&B

19
Q

Nasopharynx
What CTV
T3-4 N0

A

CTV-60: CTV-65 +5mm, whole nasopharynx, whole sphenoid sinus & ipsilateral cavernous sinus
Nodes: Bilateral 2A-5A, 7A&B

20
Q

Nasopharynx
What CTV
T3-4 N+

A

CTV-60: CTV-65 +5mm, whole nasopharynx, inferior sphenoid sinus
Nodes: Bilateral 2A-5A&B, 7A&B

21
Q

Hypopharynx
T1-2N0

A

Ipsilateral: 2-4a
Contralateral: 2-4a

22
Q

Hypopharynx
T-any, N1-2b

A

Ipsilateral: 2-4a
Contralateral: 2-4a
include 6 if pyriform sinus apex involved, post cricoid space or oesophageal extension; 7A if posterior pharyngeal wall involvement

23
Q

Hypopharynx
Tany N2c - bilateral or contralateral nodes

A

Depends on which nodes are positive
include 6 if pyriform sinus apex involved, post cricoid space or oesophageal extension or node positive ; 7A if posterior pharyngeal wall involvement

24
Q

Hypopharynx
Tany N3 - >6cm or ECE

A

Ipsilateral: 2-4a
Contralateral: 2-4a
include 6 if pyriform sinus apex involved, post cricoid space or oesophageal extension or node positive ; 7A if posterior pharyngeal wall involvement

25
Q

Larynx
T1-2 N0

26
Q

Larynx
T3-4 N0

A

Ipsilateral: 2-4a
Contralateral: 2-4a
6 if subglottic involvement

27
Q

Larynx
Tany N1-2b

A

Ipsilateral: 1b-4a, 5a-b, 7b
Contralateral: 2-4a
6 if subglottic involvement

28
Q

Larynx
Tany N2c - bilateral or contralateral nodes

A

Ipsilateral: 1b-4a, 5a-b, 7b
Contralateral: depends on nodal involvement
6 if subglottic involvement

29
Q

Larynx
N3

A

Ipsilateral: 1b-4a, 5a-b, 7b
Contralateral: 2-4a
6 if subglottic involvement

FRCR2 (38 decks)

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