Cancer Treatment Centers Overview

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Questions and Answers

What is one imaging method used if a response is observed in head and neck cancer treatment?

CT of the abdomen

Ultrasound of the head

MRI with contrast of the neck (correct)

MRI of the chest

What is the timeframe mentioned for conducting imaging after a response is observed?

6–8 weeks

8–12 weeks (correct)

12–16 weeks

4–6 weeks

Which treatment is added when the patient's performance status is PS 3?

Single-agent systemic therapy (correct)

Palliative care only

Surgery as the primary intervention

Combination chemotherapy

What is the purpose of FDG PET/CT imaging in head and neck cancer treatment?

To confirm metabolic activity after 12 weeks Signup and view all the answers

What might be done after confirming residual or persistent disease in the neck?

Neck dissection Signup and view all the answers

What modification was made to the treatment option for T4a,N0–3 in the recent NCCN guidelines?

Surgery, including ipsilateral or bilateral neck dissection Signup and view all the answers

Which new consideration was added regarding biomarker identification in the 2023 guidelines?

Consideration of NGS genomic profiling for biomarker identification Signup and view all the answers

Which version follows Version 2.2022 in the NCCN guidelines for Head and Neck Cancers?

Version 1.2023 Signup and view all the answers

What does the abbreviation NGS stand for in the context of genomic profiling?

Next Generation Sequencing Signup and view all the answers

In the updated guidelines, which of the following aspects of treatment was specifically mentioned for modification?

Surgical options for the treatment of T4a,N0–3 Signup and view all the answers

What is advised for patients who currently smoke?

They should be encouraged to quit smoking. Signup and view all the answers

What should a health history and physical examination (H&P) include regarding tobacco use?

Quantification of pack years smoked. Signup and view all the answers

What screening is recommended alongside the management of squamous cell skin cancer?

Screening for depression. Signup and view all the answers

What is the recommendation for patients who have formerly smoked?

They should remain abstinent from smoking. Signup and view all the answers

What does NCCN emphasize as beneficial for managing any patient with cancer?

Participation in clinical trials. Signup and view all the answers

Which cancer center is associated with Stanford University?

Stanford Cancer Institute Signup and view all the answers

Which of the following cancer centers is part of the University of Pennsylvania?

Abramson Cancer Center Signup and view all the answers

What is the name of the cancer center located in Indiana?

Indiana University Melvin and Bren Simon Cancer Center Signup and view all the answers

Which cancer center is associated with Johns Hopkins?

Cancer Center at Johns Hopkins Signup and view all the answers

Which of the following centers is located in California?

UCLA Jonsson Comprehensive Cancer Center Signup and view all the answers

What is the name of the cancer center associated with the University of Wisconsin?

None mentioned Signup and view all the answers

Which comprehensive cancer center is located in Colorado?

University of Colorado Comprehensive Cancer Center Signup and view all the answers

Which of these centers is associated with Vanderbilt University?

Vanderbilt-Ingram Cancer Center Signup and view all the answers

Which cancer center is located in Ohio?

The Ohio State University Cancer Center Signup and view all the answers

Which comprehensive cancer center is located in New York?

James Cancer Hospital and Solove Research Institute Signup and view all the answers

What is the recommended radiation therapy fractionation for high-risk primary tumors and involved lymph nodes?

66 Gy (2.2 Gy/fraction) to 70 Gy (2.0 Gy/fraction) over 6–7 weeks Signup and view all the answers

What is the purpose of brachytherapy in radiation therapy?

To provide targeted doses to specific areas Signup and view all the answers

For low to intermediate risk sites of suspected subclinical spread, what is the radiation dose range recommended?

44–50 Gy (2.0 Gy/fraction) to 54–63 Gy (1.6–1.8 Gy/fraction) Signup and view all the answers

What type of brachytherapy is considered for selected cases?

Low dose-rate (LDR) brachytherapy Signup and view all the answers

How is hyperfractionation delivered in radiation therapy for squamous cell skin cancer?

81.6 Gy/7 weeks at 1.2 Gy/fraction, twice daily Signup and view all the answers

What is not indicated for T1–3, N0 mucosal lip cancer according to the guidelines?

Neck dissection Signup and view all the answers

What is the recommended approach for managing cancer patients according to the guidelines?

Participation in clinical trials Signup and view all the answers

What is the specific recommendation for high-risk lymph nodes in radiation therapy?

Include possible local subclinical infiltration Signup and view all the answers

When is a concomitant boost accelerated RT applied in treatment?

In high-risk cases as an intensification strategy Signup and view all the answers

What is an example of a treatment regimen for concomitant boost accelerated RT?

72 Gy/6 weeks (1.8 Gy/fraction, large field) Signup and view all the answers

Study Notes

Comprehensive Cancer Centers

Includes notable institutions like Lurie Comprehensive Cancer Center, Fred & Pamela Buffett Cancer Center, and Abramson Cancer Center.
Other key centers: UC Davis Comprehensive Cancer Center, Stanford Cancer Institute, and Duke Cancer Institute.
Many centers are designated as Academic Cancer Centers contributing to advanced cancer research and patient care.

NCCN Guidelines for Head and Neck Cancers (Version 1.2023)

Updates include modified treatment options for primary and neck tumors at various stages (T4a,N0–3).
Newly suggested treatment modalities include genomic profiling for biomarker identification.
Imaging guidelines adjust follow-up protocols post-treatment, recommending CT scans or MRI with contrast at specified intervals based on disease response.

Treatment Protocols

Head and neck cancer patients with a performance status of 3 may be considered for single-agent systemic therapy.
Imaging advancements such as FDG PET/CT scanning are recommended 12 weeks post-treatment to evaluate potential residual disease.

Principles of Radiation Therapy

High-risk patients require precise radiation doses ranging from 66 Gy to 72 Gy over 6-7 weeks.
Low to intermediate-risk treatments range between 44 Gy to 63 Gy, indicating varied approaches based on risk levels.
Brachytherapy is an option for selected cases, including low dose-rate techniques to enhance treatment efficacy.

Smoking Cessation and Disease Management

Patients are advised to quit smoking, with support resources available through NCCN guidelines.
Screening for depression is emphasized as a critical component of head and neck cancer care.
All recommendations categorized as 2A underscore the importance of clinical trial participation for optimal patient outcomes.

Studying That Suits You

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Description

Explore various cancer treatment centers including the Lurie Comprehensive Cancer Center and other notable institutions. This quiz will test your knowledge on their facilities, specialties, and contributions to cancer research and treatment.