Nancy Lee, MD - ASTRO

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• N=77 • IV=83% RTOG 99-14 Ang JCO 2005 • 92% received RT within 5% of the protocol guideline • 89% had both cycles of CDDP • Acute G3: 66%; G4: 25 • Grade 3 mucositis: 51%; G 4: 3% • 4% died of sepsis or pneumonia • Dysphagia, BM suppression, N/V • Late toxicity 51% • Median F/U 1 year • 2 year OS 72% and DFS 54% • 2 year LRC 65% and DMFS 84%
RTOG 0129 Phase III Trial of Concurrent RT and CT for Advanced Head and Neck Cancer S T R A T I F Zubrod PS R 0or1 0 or 1 A Site : larynx vs none N D Nodal Status : O Y N0 N1 or N2a-b N2 N2c-N3 N3 M I Z E Arm 1 : AFX-CB 72 Gy/42 FXS/6 wks plus CDDP 100 Mg/M2 days 1 and 22 Arm 2 : Concurrent 70 Gy + Cisplatin 100 mg/m2 II.V. V on days 1, 1 22, 22 43 43.
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 28 and 29: RTOG 90-03 PHASE III STUDY OF ALTER
Page 32 and 33: CB: 33% Late Grade 3-4 Toxicity
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
Page 98 and 99:
Stage T3 Carcinoma of the Glottis R
Page 100 and 101:
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
Page 120 and 121:
Stage III or IV of f sq cell ll ca
Page 122 and 123:
HHypopharynx h
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EORTC 24891 LARYNX PRESERVATION FOR
Page 126:
CConcurrent Ch Chemoradiotherapy di
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Nancy Lee, MD - ASTRO

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