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Head & Neck CA

Radiation Therapy, Head and Neck CA, Treatment

QuestionAnswer
What is the most common head and neck ca? Cancer of the larynx
Nasopharynx ca may be uncommon in the states compared to what regions? Hong Kong, southern China, Taiwan, Vietnam, Thailand and the Philippines
What tissue do most of the head and neck ca arise from? epithelial, specifically squamous cell
What are the general risk factors for head and neck ca? tobacco and alcohol, UV light exposure, viral infection, and environmental exposures.
Head and neck ca account for what percent of all malignancies? 3-5%
What are three symptoms/signs of nasopharynx ca? nose bleeds headache, difficulty hearing.
Most common enlarged node in nasopharynx ca is? node of rouviere
What is leukoplakia? white patches on mucous membrane
What are alternative methods of treating the posterior cervical triangle? Electron boost beam
What area of H&N ca is treated that has no lymphatics? vocal cord
What external landmark is used for nasopharynx? midzygoma
how are the lowercervical and supraclavicular nodes treated in H&N? bilateral ap s/c
most common site of head and neck cancer is? larynx
In the 3 field H&N tx field what is the major concern for therapists? matchline
What is the 3 field setup for nasopharynx? 2 lats and an ap s/c field
What prescription is used for nasopharynx? 5040 cgy/180 cgy fx / boost to 65-75/ ap s/c field 45-50 gy/ 180 cgy
What are the areas of the larynx? glottis (true cord, most common site), supragloittis, subglottis (.5 cm below glottis to bottom of cricoid)
What is the most common presenting symptom in laryngeal ca hoarseness
What is important with positioning in h&n? that the chin is extended and shoulders droppped
What is the most common pattern of spread for true cord? direct extension to supraglottis and subglottis
What is considered to have bad prognosis in laryngeal ca? fixed cord
What would a s/c field be used in a laryngeal ca pt? T3/4 or node positive patients.
What is verrucous ca of the larynx? wart like tumors that are usually removed via surgery
What are the crit structures for vocal cord tx? Larynx (cartilage) 70 gy, spinal cord 47 Gy, larynx (cord) 45 Gy, Thyroid 45 Gy
What are the side effects of vocal cord tx? hoarseness, dysphagia, sore throat, xerostomia
What energy is used to treat vocal cord? 6 mv
what is the dose prescription for vocal cord T1 N0 MO? 66 gy/2 Gy qd / 6mv
What level of the spine is the thyroid cartilage at? c4/5
what level of the spine is the cricoid cartilage at? c6
What chemo drugs are used with H&N? single agent - methotrexate, cisplatin, carboplatin, bleomycin, 5fu. cisplatin and 5fu for combo most used
What are the critical structures for naso tx? lens 10 gy, lacrimal gland 26 gy, optic chiasm 50gy, optic nerve 50 gy, brain 47 gy, brain stem 50 gy, cord 47 gy, parotid 32 gy, ear 30 gy (acute) 55 gy (chronic)
Created by: emeriken1277