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radiation > nasopharynx > Flashcards

nasopharynx Flashcards

1
Q

Nasopharynx is more common in

A

Asia, NA, Southern China

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2
Q

Age –more than __% are less than 55 y.o.

A

50%

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3
Q

Ratio men to women

A

2:1

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4
Q

Etiology

A

DIET - nitrates, EBV, poor ENT disease, dust inhalation

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5
Q

Anatomy of nasopharynx

A

nasal fossa, sup oropharynx, lat middle ears eustachian tubes, soft palate, lateral and postsup pharynxgeal wall, adenoid

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6
Q

Most common presenting symptom

A

painless upper neck mass

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7
Q

Clinical presentation

A

epistaxis, hearing/breathing problems, headache

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8
Q

__% present with neurologic symptoms

A

25

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9
Q

Cranial nerve involvement

A

V and VI

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10
Q

Otitis

A

ear pain

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11
Q

Extension into pre vertebral muscles involve
pain upon __ of the neck

A

extension

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12
Q

2 major routes for direct spread to the brain

A

foramen lacerum and ovale

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13
Q

nerve V

A

trigeminal

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14
Q

nerve VI

A

abducens

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15
Q

Most common histology

A

SCC/epidermoid

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16
Q

__% present distant mets

A

25

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17
Q

Mets to __ is most common

A

bone then liver then lungs

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18
Q

Lymphatic spread

A

node of rouvier to sup jugular and post cervical

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19
Q

post cervical nodes

A

spinal accessory nodes

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20
Q

node of rouvier

A

retropharyngeal

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21
Q

__-__% have positive cervical nodes

A

75-80

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22
Q

__-__% bilateral/contralateral have distant mets

A

40-70

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23
Q

First clinical indication of lymphatic spread will tend to be __ __nodes

A

jugulo digastric

24
Q

___ is close to carotid so
inaccessible surgically therefore must be
included in nasopharynx treatment volume

A

node of rouvier/retropharyngeal

25
Q

__ is the first treatment of choice

A

rt

26
Q

Energy preference

A

lower: superficial structures

higher: disadvantage due to separation, sensitivity, surrounding OAR

27
Q

sup border

A

2 cm margin beyond tumor, include base of skull and sphenoid sinuses

28
Q

post border

A

2 cm magin beyond mastoid process

29
Q

ant border

A

include post 1/3 maxillary sinus and nasal cavity

30
Q

inf border

A

thyroid notch, spare larynx

31
Q

treatment arrangement

A

opposed lateral field encompass tumor and nodal spread

32
Q

dose

A

5000 cGy

33
Q

CD boost

A

6500 cGy

34
Q

dose with lymphadenopathy

A

7000

35
Q

True/False: ANT Neck fields always incorporated in treating
NP even with IMRT/3D with or without disease
present

A

true

36
Q

T1 T2 dose

A

60-70 Gy

37
Q

T3 T4 dose

A

7000

38
Q

side effects of radiation short term

A

skin change, nausea, vomiting, fatigue, mouth sore, hoarseness, loss of taste

39
Q

long term rad side effect

A

xerostomia, tooth decay, bone damage, salivary gland damage, vision/hearing loss

40
Q

chemo drug for naso

A

cisplatin

41
Q

targeted therapy

A

erbitux

42
Q

sore throat begins __ week RT

A

2

43
Q

sore throat persists for __ post RT

A

1-2 months

44
Q

TSH levels should be monitored every ___ ___

A

6-12 months

45
Q

survival

A

45%

46
Q

nasal vestibule

A

entrance to cavity, skin hair sweat glands

47
Q
A
48
Q

anatomy of nasal cavity

A

nasal vestibule
limen nasi - beginning
-paired nasal cavity sep by septal cartilage
turbinates - bony folds

49
Q

symtoms of nasal cavity cancer

A

Obstruction
* Minor intermittent bleeding
* Sinus trouble/discharge
* Orbital invasion

50
Q

spread of nasal cavity

A

direct, mid and inf turbinates

51
Q

lymph spread nasal cavity __-__% at time of diagnosis

A

10-15

52
Q

tx of nasla cavity

A

rt or surgery early lesion

53
Q

papilloma tx

A

surgery

54
Q

SCC or adeno tx nasal cavity

A

either or combo.. rt>surgery cosmesis

55
Q

nasal cavity dose

A

60-65 in 6-7 weeks

56
Q

survival nasal cavity

A

45-59%

57
Q
A

radiation (1 decks)

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