Nasopharyngeal

Question 1

Common viral etiology

Answer 1

EBV

5 year OS

Low pretreatment EBV copies & undetectable post RX: 87.2%
High pretreatment EBV copies & undetectable post RX: 71.0%
Detectable EBV copies post treatment: 38.7%

Question 2

RTOG 88-17
Intergroup 00-99

Remember ar 1988, 17th

Answer 2

Phase III trial , stage III/IV
RT vs CRT for Nasopharyngeal Ca
However, this study was not applicable to endemic regions

RT
70Gy

3 year PFS: 24%
3 year OS: 47%
CR: 36%

CRT
70Gy with cisplatin 100mg/m2 once a week for 3 weeks followed by
adjuvant chemo, (cisplatin 80mg/m2 on day 1) + (5-FU every 1-4 days) every 4 weeks x 3 cycles

3 year PFS: 69%
3 year OS: 78%
CR: 49%

Question 3

Nasopharynx staging

Answer 3

Question 4

Advantage of addition of chemotherapy either Neoadjuvant, concurrent or adjuvant vs RT alone

Answer 4

5% improvement in 5 year OS

Question 5

Nasal Cavity subsites

Answer 5

1) Septum
2) Floor
3) Lateral wall
4) Vestibule

Question 6

Nasal Cavity staging

Answer 6

Question 7

Neoadjuvant Chemo followed by CRT vs CRT

Answer 7

Neoadjuvant chemo improved OS and improved FFS!
They got 3 cycles of induction chemotherapy.