Head and Neck Cancer Flashcards
What percentage of oropharyngeal cancers are attributable to HPV?
Around 35%
Are outcomes better in HPV positive or negative disease in HNSqCC?
HPV positive
When is surgery preferred over CRT in H&N cancer?
T3-T4 oral cavity tumours and T4 pharygeal tumours.
What are first line options for metastatic HNSqCC?
Pembrolizumab if CPS >1
In rapidly progressing tumour may want to use platinum based chemotherapy in first line, not able to use combination IO.
What are second line option in HNSqCC?
Platinum based chemo if IO given in first line.
If chemo given in first line then can use Nivolumab (no PDL1 cut off)
First line management of metastatic oral cavity tumours?
Platinum + F5U + cetuximab
What is the hallmark genetic change in adenoid cystic carcinoma?
MYB/NFIB fusion translocation
EBV is associated with which type of H&N cancer?
Nasopharygeal carcinoma
What induction/adjuvant chemotherapy regime should be used in presence of EBV associated nasopharyngeal carcinoma?
Gemcitabine and cisplatin
What are risk factors for carotid blowout?
Previous RT (main one!), fistula, infection, radical resection and flap necrosis.
Which investigation is most helpful in the setting of oral/pharyngeal fibrosis post chemoradiotherapy?
Videofluoroscopy swallow as can assess both oral (voluntary) and pharyngeal (involuntary) stages of swallowing
Which H&N cancer is most likely to cause airway compromise?
Laryngeal cancer, treat with adrenaline nebs but will need tracheostomy
Which HPV subtype accounts for majority of HPCV associated HNSqCC
HPV 16
What is the most likely mechanism for EBV associated Nasopharyngeal cancer?
Promotion of proliferation via the destruction of antiproliferative proteins
