Noktehaye Konkouri
  • Chance of AML after ABVD in HL:
    • <1% in 10 years
    • Risk is higher in older patients (>35yr)
  • Chance of AML after MOPP in HL:
    • 4% in 10years
  • Risk of solid tumor after combined (CRT ) in HL:
    • After 15years is about 13%
    • After 20years —> 17%
    • After 25years —> 22%

Patient with vulvar ca and LN dissection and primary tumor resection. 3 LN+
Chance of inguinal recurrence without any treatment —> 24%


  • Anaplastic Oligodendroglioma —> Whole-arm losses of chromosomes 1p and 19q & mutations CIC
  • Anaplastic OligoAstrocytoma —> mutations of TP53
  • Both —> mutations of isocitrate dehydrogenase (IDH) & hypermethylation

  • Adjuvant RT for GBM post-op
    • 60Gy vs 45Gy
    • MS
      • 12m vs 9m

Factors associated with severe impaired swallowing in head and neck ca treated with RT:

  • Patient factors:
    • Low performance status
    • Advanced age
    • Previous dysphagia
    • Previous weight loss
    • Low body mass index
    • Heavy alcohol consumption and smoking
  • Tumor factors:
    • Hypopharynx and Larynx tumors
    • Large primary tumor
  • Treatment factors:
    • Concurrent chemotherapy
      • Cetuximab associated with loss of weight but not other toxicities
    • Post CRT neck dissection
    • hyperfractionated radiation treatment

  • HPV
    • Oropharynx
      • 16
    • Anal Cancer
      • 16, 18, 31, 33, 35
    • Cervical Cancer
      • 16, 18
    • Vulvar Cancer
      • 6, 16, 18, 33

  • Chances of developing mets in H&N Ca:
    • Highest in T4N3 Nasopharynx —> ~45%
    • Nasopharynx T2N1 —> ~30%
    • Oral cavity —> T1-T2N0 —> ~5%
    • Glottic Ca T1 —> almost none

Most common serious side effect after RT and Chemo for Breast Cancer ( specially left side ); specially Her2+ is cardiovascular side effect.


Head and Neck Prognostic Factor:

  • For survival, most predictive factor —> T stage
    • 2nd most important:
      • T1-T2 —> tumor location
      • T3-T4 —> KPS
  • For LRC —> N stage
    • 2nd most important factor:
      • N0 —> T stage
      • N+ —> number of treatment fractions

Survival: Groups:

RPA Class Median Survival 2yr OS
1 10yrs 90%
2 5yrs 70%
3 2yr 50%
4 18m 45%
5 10m 20%