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Head and Neck Cancers • Medical Oncology
Do you offer induction chemotherapy for patients with cT4N0 laryngeal cancer who decline surgery and are not candidates for high dose cisplatin-based concurrent RT?
NCCN suggests either concurrent chemoRT or induction chemotherapy in these patients.
Answer from: Medical Oncologist at Community Practice
any curative intent treatment with cisplatin would be high dose. are they not candidates for cisplatin or RT?
If renal issues and not candidates for cisplatin, would go with carbo/taxol or cetuximab with definitve RT
If not candidate for RT, would go with palliative intent chemo+immunotherapy
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Answer from: Medical Oncologist at Community Practice
The main benefit of Induction chemotherapy is improvement of distant failures, therefore it’s a reasonable alternative to CRT for Hypopharynx, and other sites with N3 disease. For a T4N0 Larynx the main problem is local control (besides the functional problem of course), therefore I do n...
Answer from: Medical Oncologist at Academic Institution
The best option is concurrent radiotherapy + chemotherapy (CRT). I agree with options for non-cisplatin concurrent as per Dr. Seetharamu.
Induction chemotherapy followed by radiotherapy alone (if unable to tolerate CRT) is also reasonable.
It is not standard of care, but if the CPS score for...
Answer from: Medical Oncologist at Community Practice
I agree with trying as much as possible to do concurrent chemo rad.
I am pleasantly surprised by inferiority of cetuximab to cisplatin concurrently in the most recent data. I wonder if it’s because they can’t take cisplatin due to risk of neutropenia or renal failure.
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