Nancy Lee, MD - ASTRO

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RTOG 91-11 Phase III Trial to Preserve the Larynx y Chemotherapy Arm 1: Cisplatin 100 mg/m / 2 + 5-FU 1 gm/m / 2 / /hr infusion over 120 hours. 3 cycles, three weeks apart apart. Arm 2: Cisplatin 100 mg/m 2 on days 1, 22, and 43 of RT. Radiation Therapy Arms 1, 2, and 3: 70 Gy/35 / fx's/7 / weeks. Treatment for Arm 1 will begin 3 weeks after the start of the third chemo cycle or 2-3 2 3 surgery as applicable. weeks after
RTOG 91-11 VA CCRT RT 2 year Laryng-FS 75% 88% 70% 2 year LR control 61% 78% 56% 5-yr. D-F Survival 38% 36% 27% 5-yr. Survival 55% 54% 56% Median F/U 3.8 years * Estimated from survival curves Update 2006 abstract shows induction arm has Better preservation rates than RT alone arm
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Head and Neck II: Oropharynx, Laryn
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OROPHARYNX-Sites Base of tongue Sof
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INCIDENCE OF LYMPH NODE METASTASES
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CA. OF THE OROPHARYNX INCIDENCE OF
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Oropharyngeal CA: Treatment Volume
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RTOG 73-03 Oral Cavity And Orophary
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Surgery and Adjuvant RT vs. CCRT in
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Stage III/IV Head and Neck CA: Rand
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CA. OF THE TONSILLAR REGION LOCAL C
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CARCINOMA OF THE TONSIL LOCAL CONTR
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BASE OF TONGUE IMPLANTS Patient Sel
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BASE OF TONGUE IMPLANTS Dose to the
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Trans-Tasman Radiation Oncology PPo
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RTOG 90-03 PHASE III STUDY OF ALTER
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CB: 33% Late Grade 3-4 Toxicity
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• N=77 • IV=83% RTOG 99-14 Ang
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Gortec French Study DDenis i et t a
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French Trial: Oropharyngeal CA (D (
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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 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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