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
- Concurrent chemotherapy
- HPV
- Oropharynx
- 16
- Anal Cancer
- 16, 18, 31, 33, 35
- Cervical Cancer
- 16, 18
- Vulvar Cancer
- 6, 16, 18, 33
- Oropharynx
- 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
- 2nd most important:
- For LRC —> N stage
- 2nd most important factor:
- N0 —> T stage
- N+ —> number of treatment fractions
- 2nd most important factor:
Survival: Groups:
RPA Class | Median Survival | 2yr OS |
---|---|---|
1 | 10yrs | 90% |
2 | 5yrs | 70% |
3 | 2yr | 50% |
4 | 18m | 45% |
5 | 10m | 20% |
page revision: 21, last edited: 03 Dec 2012 23:53