Head and neck cancer

Head And Neck Cancer

head neck cancer

Which chemotherapy regimen has randomized data supporting improvement in PFS for recurrent nasopharyngeal carcinoma ?

View Answer
View Question

Gemcitabine + cisplatin

head neck cancer
head neck cancer

Has an OS ever been demonstrated with induction chemo prior to chemoradiotherapy for nasopharyngeal carcinoma ?

View Answer
View Question

Yes, Gemcitabine/Cisplatin B2013-022-01 trial

head neck cancer
Head and neck cancer

How do you manage residual disease in stage I/II lip SCC that was treated with primary
chemoradiotherapy?

View Answer
View Question

surgery – neck dissection

Head and neck cancer
Head and neck cancer

How do you manage head and neck squamous cell carcinoma of the lip with positive lymph nodes?

View Answer
View Question

Neck dissection post-radiotherapy

Head and neck cancer
Head and neck cancer

When do we consider a radical neck dissection with stage I/II head and neck CA?

View Answer
View Question

Positive lymph nodes

Head and neck cancer
Head and neck cancer

What are the TNM criteria for stage I/II squamous cell carcinoma of the lip?

View Answer
View Question

T<4 cm, NO lymphadenopathy, no local invasion

Head and neck cancer
Head and neck cancer

Which 2 oral cavity cancers aren’t at high risk from HPV?

View Answer
View Question

Tonsil and base of tongue

Head and neck cancer
Head and neck cancer

What Constitutes the oral cavity?

View Answer
View Question

Floor of the mouth, lips, buccal mucosa, hard palate, retromolar trigone, oral tongue, lower alveolar
ridge, upper alveolar ridge

Head and neck cancer
Head and neck cancer

When would you consider radiotherapy after resection for stage I or stage II oral cavity squamous cell
carcinoma?

View Answer
View Question

Positive margins, lymphovascular invasion, perineural invasion, greater than or equal to 4 mm thickness
primary tumor, poor surgical candidacy

Head and neck cancer
Head and neck cancer

Should stage I or stage II oral cavity squamous cell carcinoma status post surgery with positive margins
have resection or radiotherapy?

View Answer
View Question

Reresection

Head and neck cancer
Head and neck cancer

Do upper or lower lip squamous cell carcinoma have a worse prognosis?

View Answer
View Question

Upper

Head and neck cancer
Head and neck cancer

What is the standard of care for stage III nasopharyngeal carcinoma?

View Answer
View Question

Concurrent chemoradiotherapy plus bilateral neck irradiation

Head and neck cancer
Head and neck cancer

What is the recommended first-line therapy for stage I
and stage II oral cavity squamous cell carcinoma?

View Answer
View Question

Surgery

Head and neck cancer
Head and neck cancer

How are stage I and stage II head and neck cancer managed?

View Answer
View Question

Surgery or radiotherapy

Head and neck cancer
Head and neck cancer

What defines stage I and stage II head and neck cancer?

View Answer
View Question

TisN0, T1N0, T2N0

Head and neck cancer
Head and neck cancer

What is the difference between T4a and T4b hypopharyngeal cancer?

View Answer
View Question

T4a invasion of thyroid cartilage, hyoid bone, thyroid gland, central compartmental soft tissue
T4b prevertebral fascia, encases carotid, positive mediastinal structures

Head and neck cancer
Head and neck cancer

How do you manage stage III or stage IV oropharyngeal cancer?

View Answer
View Question

Concurrent chemoradiotherapy or induction chemotherapy followed by radiotherapy or concurrent
chemoradiotherapy

Head and neck cancer
Head and neck cancer

How can you treat T2N1 oropharyngeal cancer?

View Answer
View Question

Concurrent chemoradiotherapy

Head and neck cancer
Head and neck cancer

What are the anatomic boundaries of the hypopharynx?

View Answer
View Question

Piriformis sinus, post cricoid area, posterior pharyngeal wall

Head and neck cancer
Head and neck cancer

What is the preferred modality for stage III or stage IV oral cavity squamous cell carcinoma?

View Answer
View Question

Surgery of primary neck dissection

Head and neck cancer
Head and neck cancer

Which early stage oropharyngeal cancer has a unique treatment ?

View Answer
View Question

T2N1

Head and neck cancer
Head and neck cancer

What is the difference between T1 and T2 oral cavity squamous cell carcinoma with positive margins
with regards to management?

View Answer
View Question

T1 – radiotherapy or surgery
T2–chemoradiotherapy

Head and neck cancer
Head and neck cancer

When would you offer adjuvant radiotherapy versus concurrent chemoradiotherapy for Stage I or stage
II head and neck oral cavity squamous cell carcinoma?

View Answer
View Question

The presence of any adverse features including extracapsular spread, nodal spread, positive margins,
pathological T3, pathologic T4, vascular embolism, level IV level V lymph node, perineural invasion–offer
concurrent chemoradiotherapy

Head and neck cancer
Head and neck cancer

What else can be offered besides primary tumor resection for head and neck oral cavity squamous cell
carcinoma, stage I and stage II?

View Answer
View Question

Lymph node dissection

Head and neck cancer
Head and neck cancer

When would you not offer surgery for stage I or stage II oral cavity squamous cell carcinoma?

View Answer
View Question

If no residual disease is present following radiotherapy

Head and neck cancer
Head and neck cancer

When would you choose postoperative concurrent chemoradiotherapy versus radiotherapy in adjuvant
stage I and stage II laryngeal cancer ?

View Answer
View Question

R1 surgery and extracapsular lymph node involvement use concurrent chemoradiotherapy
All others with high-risk features these radiotherapy

Head and neck cancer
Head and neck cancer

What are the differences in primary definitive therapy for supraglottic and subglottic laryngeal cancer?

View Answer
View Question

Subglottic total laryngectomy plus thyroidectomy post lymph node dissection
Supraglottic radiotherapy

Head and neck cancer
Head and neck cancer

What is the role of HPV as a biomarker for head and neck cancer?

View Answer
View Question

Prognostic but not predictive

Head and neck cancer
Head and neck cancer

What are the relevance of the EORTC 22931 and RTOG 9501 clinical trials for stage III and stage IV
head and neck SCC of the oral pharynx and larynx?

View Answer
View Question

Patients with positive margins or extracapsular invasion who underwent concurrent chemoradiotherapy
versus radiotherapy showed an improvement in overall survival of 53% versus 40%

Head and neck cancer
Head and neck cancer

For stage III or stage IV hypopharyngeal cancer, if the patient has less than a partial response to
induction chemotherapy, what is recommended?

View Answer
View Question

Surgery first

Head and neck cancer
Head and neck cancer

What are category 1 recommendations following induction chemotherapy for hypopharyngeal cancer if
a complete response is achieved?

View Answer
View Question

Radiotherapy category 1
Concurrent chemoradiotherapy category 2B

Head and neck cancer
Head and neck cancer

Which 2 head and neck cancers have a role for induction chemotherapy?

View Answer
View Question

Stage III and stage IV oropharyngeal CA and hypopharyngeal CA

Head and neck cancer
Head and neck cancer

How do you manage positive margins in stage I or stage II hypopharyngeal cancer?

View Answer
View Question

Reresection or radiotherapy or concurrent chemoradiotherapy

Head and neck cancer
Head and neck cancer

What surgery is ideal for hypopharyngeal cancer?

View Answer
View Question

Partial laryngeal pharyngectomy i.e. larynx sparing

Head and neck cancer
Head and neck cancer

What is the major morbidity associated with hypopharyngeal carcinoma?

View Answer
View Question

Dysphagia and aspiration

Head and neck cancer
Head and neck cancer

Is surgery or radiotherapy preferred for early stage I or stage II hypopharyngeal cancer?

View Answer
View Question

No change in outcomes depends on likelihood of achieving R0 surgical resection

Head and neck cancer
Head and neck cancer

What are the treatment modalities for stage I and stage II glottic laryngeal cancer ?

View Answer
View Question

Radiotherapy or partial laryngectomy with or without neck dissection

Head and neck cancer
Head and neck cancer

What is the treatment for carcinoma in situ of the larynx?

View Answer
View Question

Endoscopic resection

Head and neck cancer
Head and neck cancer

What is the difference between induction chemotherapy approaches for T4a N0, 1, 2, 3 versus T1, T2, T3
N0,1,2,3 ?

View Answer
View Question

T3 and T4a–after induction chemotherapy with less than a partial response:

T4 – surgery followed by radiotherapy
Others: surgery but adjuvant radiotherapy depending on the presence of adverse features

Head and neck cancer
Head and Neck Cancer Part 2

Which phase 3 trial has been the only one to demonstrate an improvement in OS with the cetuximab in the definitive setting for H&N CA ?

View Answer
View Question

IMCL-9815, comparator arm was radiotherapy

Head and Neck Cancer Part 2
Head and Neck Cancer

What did the TREMPLIN trial show ?

View Answer
View Question

No improvement in larynx preservation after induction chemotherapy followed by definitive radiotherapy with either concurrent chemo or cetuximab

Head and Neck Cancer
Head and Neck Cancer

Has an OS been demonstrated for cetuximab + radiotherapy for definitive treatment of head and neck cancer versus cisplatin + radiotherapy ?

View Answer
View Question

No

Head and Neck Cancer
Head and Neck Cancer

Is there randomized data showing an OS benefit of cetuximab in second and later line therapy in SCC of the H&N ?

View Answer
View Question

No, only comparator arm in CheckMate 141 which was inferior to nivolumab

Head and Neck Cancer
Head and Neck Cancer

Which Phase III trial showed a survival advantage in first-line metastatic SCC of the Head & Neck ?

View Answer
View Question

EXTREME

Head and Neck Cancer
Head and Neck Cancer

Which EGFR TKI has shown an improvement in PFS in advanced refractory SCC of the H&N ?

View Answer
View Question

Afatinib

Head and Neck Cancer
Head and Neck Cancer

Is there randomized data supporting the use of nivolumab in recurrent SCC of the head and neck ?

View Answer
View Question

Yes, CheckMate 141

Head and Neck Cancer
Head and Neck Cancer

Is there randomized data supporting the use of pembrolizumab in recurrent SCC of the head and neck ?

View Answer
View Question

Yes, KEYNOTE-040 trial

Head and Neck Cancer
Head and neck cancer

Which treatment approach is recommended for laryngeal preservation in head and neck cancer?

View Answer
View Question

Concurrent chemoradiotherapy

Head and neck cancer
Head and neck cancer

What advantage is there for panitumumab over cetuximab for relapsed or refractory metastatic head
and neck cancer?

View Answer
View Question

None

Head and neck cancer
Head and neck cancer

The addition of which agent to platinum agent plus 5-FU has increased overall survival with relapse /
refractory metastatic head and neck squamous cell carcinoma?

View Answer
View Question

Cetuximab

Head and neck cancer
Head and neck cancer

Which chemotherapy doublet is ideal for relapsed or refractory metastatic H&N SCC?

View Answer
View Question

Platinum agent plus 5-FU

Head and neck cancer
Head and neck cancer

What is a good prognostic biomarker for head and neck squamous cell carcinoma?

View Answer
View Question

HPV positive oropharyngeal cancer

Head and neck cancer
Head and neck cancer

When should one use combination platinum plus Cetuximab versus sequential platinum followed by
Cetuximab for relapsed / refractory head and neck squamous cell carcinoma?

View Answer
View Question

Does not matter

Head and neck cancer
Head and neck cancer

What is the overall response rate for pembrolizumab in relapsed refractory cancer?

View Answer
View Question

16%

Head and neck cancer
Head and neck cancer

What is an important biomarker for nivolumab response for relapsed refractory head and neck cancer?

View Answer
View Question

HPV positive.

Head and neck cancer
Head and neck cancer

What is the overall response rate of Cetuximab for platinum refractory head and neck squamous cell
carcinoma?

View Answer
View Question

13%

Head and neck cancer
Head and neck cancer

Which TKI has activity in relapsed/refractory head and neck cancer?

View Answer
View Question

Afatinib

Head and neck cancer
Head and neck cancer

Which head and neck primary SCC has the best prognosis ?

View Answer
View Question

Oral cavity

Head and neck cancer
Head and neck cancer

When should a PD–L1 agent not be used for head and neck cancer?

View Answer
View Question

If an immediate disease response is required

Head and neck cancer
Head and neck cancer

Which biologic agents are active in refractory or recurrent head and neck cancer?

View Answer
View Question

PD–L1, cetuximab

Head and neck cancer
Head and neck cancer

Which chemotherapy agents are active in relapsed or refractory head and neck squamous cell
carcinoma?

View Answer
View Question

Cis-platinum, carboplatin, 5-FU, Taxol, docetaxel, methotrexate

Head and neck cancer
Head and neck cancer

How is N3 disease staged in head and neck cancer?

View Answer
View Question

Stage IV

Head and neck cancer
Head and neck cancer

What defines N1 disease for head and neck cancer?

View Answer
View Question

Ipsilateral LN, smaller than 3 cm

Head and neck cancer
Head and neck cancer

With defines N3 disease in head and neck cancer?

View Answer
View Question

Larger than 6 cm

Head and neck cancer
Head and neck cancer

What comprises the pharynx?

View Answer
View Question

Nasopharynx, oropharynx, hypopharynx

Head and neck cancer
Head and neck cancer

Why are growth factors not used for head and neck cancer stage III stage IV undergoing
chemoradiotherapy?

View Answer
View Question

Promotes tumor growth

Head and neck cancer
Head and neck cancer

What geographical region has a high side effect profile with cetuximab infusions?

View Answer
View Question

Southeast United States

Head and neck cancer
Head and neck cancer

What is the most common toxicity with cetuximab+ concurrent chemoradiotherapy?

View Answer
View Question

Dermatitis

Head and neck cancer
Head and neck cancer

When is there a role for surgery in stage III or stage IV head and neck cancer?

View Answer
View Question

If only a partial response is obtained from chemoradiotherapy

Head and neck cancer
Head and neck cancer

Which patients would ideally benefit from induction chemotherapy followed by concurrent
chemoradiotherapy?

View Answer
View Question

High risk of local failure or distant recurrence, N2 and N3 disease

Head and neck cancer
Head and neck cancer

What is the benefit of induction chemotherapy in stage III and stage IV head and neck cancer ?

View Answer
View Question

Unclear

Head and neck cancer
Head and neck cancer

Which variable is inversely correlated to a lack of response to concurrent chemoradiotherapy for stage
III and stage IV head and neck cancer?

View Answer
View Question

increasing age is associated with lower response
very poor response in patients older than 70

Head and neck cancer
Head and neck cancer

Which head and neck cancer is excluded from most meta-analyses ?

View Answer
View Question

Primary nasopharyngeal

Head and neck cancer
Head and neck cancer

Which regimen is recommended for induction chemotherapy for head and neck cancer?

View Answer
View Question

TPF

Head and neck cancer
Head and neck cancer

Which patients should have sequential chemotherapy followed by concurrent chemoradiotherapy ?

View Answer
View Question

Heavy lymph node burden, N2, N3
Laryngeal cancer

Head and neck cancer
Head and neck cancer

What are the 3 types of nasopharyngeal carcinoma?

View Answer
View Question

Type I squamous cell carcinoma seen in America
Type II nonkeratinizing seen in China North Africa
Type III undifferentiated seen in China North Africa

Head and neck cancer
en_USEnglish