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Dose constraints, staging and prescriptions > Nasopharynx > Flashcards

Nasopharynx Flashcards

1
Q

Nasopharynx staging: Tumor confined to the nasopharynx or extension to oropharynx and/or nasal cavity without parapharyngeal involvement

A

T1

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2
Q

Nasopharynx staging: Tumor with extension to parapharyngeal space, and/or adjacent soft tissue involvement (medial pterygoid, lateral pterygoid, prevertebral muscles)

A

T2

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3
Q

Nasopharynx staging: Tumor with infiltration of bony structures at skull base, cervical vertebra, pterygoid structures, and/or paranasal sinuses

A

T3

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4
Q

Nasopharynx staging: Tumor with intracranial extension, involvement of cranial nerves, hypopharynx, orbit, parotid gland, and/or extensive soft tissue infiltration beyond the lateral surface of the lateral pterygoid muscle

A

T4

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5
Q

Nasopharynx staging: Metastasis in unilateral cervical lymph nodes and/or unilateral or bilateral metastasis in retropharyngeal lymph nodes, 6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage

A

N1

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6
Q

Nasopharynx staging: Metastasis in bilateral cervical lymph nodes, 6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage

A

N2

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7
Q

Nasopharynx staging: Metastasis unilateral or bilateral metastasis in cervical lymph nodes, larger than 6 cm in greatest dimension, and/or extension below the caudal border of cricoid cartilage

A

N3

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8
Q

Nasopharynx staging: T1N0M0

A

Stage I

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9
Q

Nasopharynx staging: T1N1 or T2N0-1

A

Stage II

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10
Q

Nasopharynx staging: T1-2N2 or T3N0-2

A

Stage III

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11
Q

Nasopharynx staging: T4N0-2 or T(any)N3

A

Stage IVA

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12
Q

Nasopharynx staging: T(any)N(any)M1

A

Stage IVB

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13
Q

Nasopharynx work-up

A

H&P, fiberoptic exam
Biopsy of primary or FNA of node
MRI skull base to clavicle, PET
EBV/HPV testing
Dental, nutrition, speech, audiogram, eye exam, smoking cessation, fertility, hep B,
Multi D discussion

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14
Q

Nasopharynx Tx paradigm: T1N0M0

A

Definitive RT (elective node, bilateral RP and II-IV)

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15
Q

Nasopharynx Tx paradigm: T2N0M0

A

Definitive RT +/- systemic therapy (bulky tumor, high serum EBV DNA copy number)

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16
Q

Nasopharynx Tx paradigm: T1-2N1 or T3N0

A

CRT, consider induction or adjuvant CT (bulky/high serum EBV)

17
Q

Nasopharynx Tx paradigm: T3N1-3, T4N0-3, T1-2N2-3

A

Clinical trial or Induction CT followed by CRT (preferred)

18
Q

Nasopharynx Tx paradigm: Induction chemo agents

A

Gem/Cisplatin preferred

19
Q

Nasopharynx Tx paradigm: Concurrent and adjuvant agent

A

Cisplatin, then Cis/5FU

Dose constraints, staging and prescriptions (27 decks)

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