Management of LocoregionallyAdvanced Laryngeal Cancer...ESMO Preceptorship Programme Management of...
Transcript of Management of LocoregionallyAdvanced Laryngeal Cancer...ESMO Preceptorship Programme Management of...
ESMO Preceptorship Programme
Management ofLocoregionally Advanced Laryngeal
Cancer
Erald Ruci
University Hospital ”Mother Teresa”
Head and Neck Cancers – Zurich, Switzerland – 22-23 May 2018
ESMO PRECEPTORSHIP PROGRAMME
Patient Background
� 61-year-old male presented with a 10-month history
of hoarseness and sore throat.
� He also reported of a lump in his left neck.
� He smoked 1 pack of cigarettes per day for 40
years and quit approximately 3 months ago.
� Other comorbidities: Hypertension under treatment.
ESMO PRECEPTORSHIP PROGRAMME
Work-up
� A 3-cm node is identified on physical examination, and computed tomography (CT) scan of the neck reveals the presence of a mass in the preepiglottic space and an enlarged jugulodigastric lymph node.
� Rigid direct laryngoscopy: Exophytic mass in laryngeal surface of epiglottis which invades the larynx entrance.
� Biopsy: Squamous cell carcinoma, G2; 3 from 13 lymph nodes metastatic; thyroid cartilage invasion.
� Imaging of the chest shows no evidence of metastasis. The tumor is classified as stage IV A (T3N2M0).
ESMO PRECEPTORSHIP PROGRAMME
Treatment
� Initially total laryngectomy with bilateral neck
dissection is performed.
� Followed by concurrent chemoradyotherapy.
� Cisplatin 50 mg weekly+RT 5days/week for 6 weeks up 60 Gy for laryngeal region
and bilateral cervical LN stations.
ESMO PRECEPTORSHIP PROGRAMME
Follow-Up
� During Radiotherapy patient develops erythema G1,
mucositis G2 ,dysphagia .
� 1 month after completion of Chemo-Radiation, the
patient was T0N0M0.
� The patients remains disease free since February
2017.
� Regular follow-ups every 3 months.
ESMO PRECEPTORSHIP PROGRAMME
Discussion
� Which would be your initially treatment, surgery as
in this case or induction chemotherapy followed by
chemoradiation or just concurrent
chemoradyotherapy?
� Do you suggest to include in follow-up the PET-CT
even if it continues to be T0N0M0?
ESMO PRECEPTORSHIP PROGRAMME