Nasopharynx

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5 Terms

1
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Stage I and II

  • T1-2 N0 M0

  • High dose RT

  • Surgery impractical

2
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Stage III and IV

  • T1-4 N0-3 M0/1

  • Concurrent chemo + RT

  • Cisplatin-based chemo regimen

  • Surgery impractical

3
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Radiotherapy management

  • Prophylactic bilateral irradiation

  • CT with contrast and MR co-registeration

  • Dental assessment

  • Weekly review by H+N team

  • Routine reviews by SALT + dietician

  • Weekly FBC

  • Weekly weight

  • Reviewed until acute SE settled

4
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Radiotherapy essentials

  • 70Gy/35#/7 weeks

  • 54-60Gy for high risk areas

  • Category 1 pt

  • Technique: IMRT/VMAT

  • CBCT

  • Supine

  • Thermoplastic mask

  • Dentures removed

OARs:

  • Oral cavity

  • Optic nerve

  • Eye

  • Cord

  • Brain stem

  • Parotid

  • mandible

  • Larynx

5
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CTV must incude

  • Nasopharynx

  • Base of skull

  • Clivus

  • Sphenoid sinus

  • Maxillary sinus

  • Irradiation of level II, III, IV, V nodal areas