Devita, Hellman, and Rosenberg's Cancer

LWBK1006-17 LWW-Govindan-Review December 7, 2011 21:14

198 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

Question 17.14. A 56-year-old woman presents to her primary care physician with left-

sided facial swelling and facial drooping. The patient has weakness of the

lower portion of her facial nerve and a palpable parotid mass. A biopsy

is performed showing a high-grade mucoepidermoid carcinoma. There

are no palpable neck lymph nodes. What is the best treatment for this

patient?

A. Radiation

B. Chemoradiation

C. Surgery

D. Surgery followed by adjuvant radiation

Question 17.15. Which of the following statements is FALSE?

A. Treatment of head and neck cancer requires a multidisciplinary

team, including medical oncologists, otorhinolaryngologists, radia-

tion oncologists, nurses, speech therapists, nutritionists, and social

workers.

B. Once the patient is able to get nutrition via a G-tube, there is no benefit

from having the patient continue to swallow during radiation.

C. Intensity-modulated radiation therapy (IMRT) can decrease xerosto-

mia in patients treated with radiation for head and neck cancer.

D. The severity of the side effects of radiation depends on the radiation

field, the radiation dose, and the concomitant chemotherapy agents.

Question 17.16. All of the following statements are true regarding second primaries in

patients with SCCHN, EXCEPT:

A. Low dose isotretinoin is ineffective in preventing second primaries.

B. Never smokers with resected SCCHN have a lower incidence of

second primaries.

C. Treatment with -tocopherol decreases the incidence of second

primary cancers.

D. Treatment with-carotene decreases the incidence of second primary

cancers.

Question 17.17. Which of the following statements regarding induction chemotherapy in

the treatment of SCCHN is NOT true?

A. Treatment with concurrent chemoradiation with cisplatin resulted in

improved overall survival compared to induction cisplatin and 5FU

followed by radiation therapy

B. Addition of docetaxel to cisplatin and 5FU was associated with supe-

rior overall survival when compared to cisplatin and 5FU alone in

the TAX 324 trial.

C. Induction chemotherapy has the potential for organ preservation.

D. Patients with unresectable SCCHN are candidates for induction

chemotherapy followed by concurrent chemoradiation.