Nancy Lee, MD - ASTRO

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An example of patient with late effect • 62 year old T3N2b SCC of the tonsil • Concurrent CDDP chemotherapy with radiation to 72 Gy Gy, COT 11/2003. 11/2003 Patient also underwent ND with no residual disease. • LLast t ffollow-up ll 3/2010 3/2010: NED bby PE and d iimaging i • However, patient had severe secondary late effects: PEG-dependent, trach-dependent, severe pharyngeal stricture, respiratory obstruction, altered phonation phonation.
An example of patient with late effect • Patient was treated with delayed concomitant boost technique. • Initial stage T3N2 disease • Opposed lateral technique • Neck dissection
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 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 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
Page 112 and 113:
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
Page 124 and 125:
EORTC 24891 LARYNX PRESERVATION FOR
Page 126:
CConcurrent Ch Chemoradiotherapy di
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Nancy Lee, MD - ASTRO

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