Follow-up/Toxicity

Question 1

Why is brachytherapy generally avoided for gingival lesions?

Answer 1

There is a high risk of osteoradionecrosis with brachytherapy for gingival lesions.

Question 2

To avoid malnutrition during a course of RT or CRT, pts need at least how many calories/day?

Answer 2

To avoid malnutrition during a course of RT or CRT, pts need at least 2,000 calories/day.

Question 3

The mandible should be kept at or below what RT dose?

Answer 3

The max mandibular RT dose should be ≤70 Gy.

Question 4

What does the f/u for OCC pts entail (NCCN 2018)?

Answer 4

OCC follow-up: H&P + laryngoscopy (q1–3 mos for yr 1, q2–6 mos for yr 2, q4–8 mos for yrs 3–5, and q12 mos if >5 yrs), imaging (for signs/Sx), annual TSH (if the neck is irradiated), speech/hearing/dental evaluation, and smoking cessation