Nancy Lee, MD - ASTRO

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RTOG 90-03 PHASE III STUDY OF ALTERED FRACTIONATION VS VS. STANDARD FRACTIONATION FOR H & N Ca. S T R A Site R A Oral Cavity Oropharynx Larynx Hypopharynx yp p y N D 1. Standard Fractionation 2. Hyperfractionation T I Stage N0 vs N+ O M 3. Accelerated Fractionation (Split-Course) F Y KPS 90-100 vs 60 60-80 80 I Z E 4. Accelerated Fractionation (Concomitant Boost)
RTOG 90-03 PHASE III STUDY OF ALTERED FRACTIONATION VS. STANDARD FRACTIONATION FOR H & N Ca. FRACTIONATION SCHEMES 1. Standard Fractionation T.D.: 70.0 Gy/35 fx/7 wks 2.0 Gy/fx Q.D. 2. Hyperfractionation T.D.: 81.6 Gy/68 fx/7 wks 1.2 Gy/fx B.I.D. 3. Accelerated Fractionation T.D.: 67.2 Gy/42 fx/6 wks (Split Course) 2 wk split at 38.4 Gy 16Gy/fx 1.6 Gy/fx B.I.D. BID 4. Accelerated Fractionation T.D.: 72.0 Gy/42 fx/6 wks (Concomitant Boost) 18Gy/fx/dtolargefield+15 1.8 Gy/fx/d to large field + 1.5 Gy/fx /d to boost field X 12 fxs. in last 2.5 wks
Page 1 and 2: Head and Neck II: Oropharynx, Laryn
Page 4 and 5: OROPHARYNX-Sites Base of tongue Sof
Page 6 and 7: INCIDENCE OF LYMPH NODE METASTASES
Page 8 and 9: CA. OF THE OROPHARYNX INCIDENCE OF
Page 10 and 11: Oropharyngeal CA: Treatment Volume
Page 12 and 13: RTOG 73-03 Oral Cavity And Orophary
Page 14 and 15: Surgery and Adjuvant RT vs. CCRT in
Page 16 and 17: Stage III/IV Head and Neck CA: Rand
Page 18 and 19: CA. OF THE TONSILLAR REGION LOCAL C
Page 20 and 21: CARCINOMA OF THE TONSIL LOCAL CONTR
Page 22 and 23: BASE OF TONGUE IMPLANTS Patient Sel
Page 24 and 25: BASE OF TONGUE IMPLANTS Dose to the
Page 26 and 27: Trans-Tasman Radiation Oncology PPo
Page 32 and 33: CB: 33% Late Grade 3-4 Toxicity
Page 34 and 35: • N=77 • IV=83% RTOG 99-14 Ang
Page 36 and 37: Gortec French Study DDenis i et t a
Page 38 and 39: French Trial: Oropharyngeal CA (D (
Page 40 and 41: There is also site-specific orophar
Page 42 and 43: Why shouldn’t we just treat all a
Page 44 and 45: Chemoradiotherapy: Late FT Dependen
Page 46 and 47: Chemoradiotherapy: Late FT Dependen
Page 48 and 49: An example of patient with late eff
Page 50 and 51: Historical RT Dose Escalation • I
Page 52 and 53: IMRT in the Treatment of Oropharyng
Page 54 and 55: Patients Population From 9/1998 to
Page 56 and 57: Local Control 3-year 94.4% 5-year 9
Page 58 and 59: Local Failure versus T-stage • T1
Page 60 and 61: Toxicities : Acute • Mucositis gr
Page 62 and 63: IMRT for oropharynx: available data
Page 64: Mean Doses Right Parotid 19.80 Gy R
Page 70 and 71: % >G2 LENT SOM Subjective Xerostomi
Page 72 and 73: Conclusions • RT preferred f d ov
Page 74 and 75: Conclusions • Careful selection o
Page 76 and 77: T1 T1-2NO 2NO Gl Glottic tti Cancer
Page 78 and 79:
T1 Carcinoma of the Glottis Local C
Page 80 and 81:
LOCAL CONTROL OF T1 LESIONS Locall
Page 82 and 83:
T2 Carcinoma of the Glottis Local o
Page 84 and 85:
LOCAL CONTROL OF T2 LESIONS Control
Page 86 and 87:
LOCAL CONTROL FOR T2 LESIONS Local
Page 88 and 89:
Randomized trial on RT fraction siz
Page 90 and 91:
Meta-analysis of Impaired VC Mobili
Page 92 and 93:
RTOG 91-11 Phase III Trial to Prese
Page 94 and 95:
T4 T4a: Thyroid Th id Cartilage C i
Page 96 and 97:
Induction Chemotherapy Followed By
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Stage T3 Carcinoma of the Glottis R
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Carcinoma of the Supraglottis % LLo
Page 102 and 103:
VA LARYNGEAL CA. STUDY Surgery Radi
Page 104 and 105:
VA LARYNX PRESERVATON STUDY Surgery
Page 106 and 107:
R A N D O M GETTEC Trial - T3 Laryn
Page 108 and 109:
Does Vocal Cord Fixation Preclude N
Page 110 and 111:
RTOG 91-11 Ph Phase III TTrial i l
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RTOG 91-11 Induction CCRT RT 2 year
Page 114 and 115:
Squamous Cell Head and Neck Cancer
Page 116 and 117:
Functional Organ Preservation with
Page 118 and 119:
Wh What t is i th the bbest t RT FF
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Stage III or IV of f sq cell ll ca
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HHypopharynx h
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EORTC 24891 LARYNX PRESERVATION FOR
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CConcurrent Ch Chemoradiotherapy di
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Nancy Lee, MD - ASTRO

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