nasopharynx

Question 1

Nasopharynx is more common in

Answer 1

Asia, NA, Southern China

Question 2

Age –more than __% are less than 55 y.o.

Answer 2

50%

Question 3

Ratio men to women

Answer 3

2:1

Question 4

Etiology

Answer 4

DIET - nitrates, EBV, poor ENT disease, dust inhalation

Question 5

Anatomy of nasopharynx

Answer 5

nasal fossa, sup oropharynx, lat middle ears eustachian tubes, soft palate, lateral and postsup pharynxgeal wall, adenoid

Question 6

Most common presenting symptom

Answer 6

painless upper neck mass

Question 7

Clinical presentation

Answer 7

epistaxis, hearing/breathing problems, headache

Question 8

__% present with neurologic symptoms

Answer 8

25

Question 9

Cranial nerve involvement

Answer 9

V and VI

Question 10

Otitis

Answer 10

ear pain

Question 11

Extension into pre vertebral muscles involve
pain upon __ of the neck

Answer 11

extension

Question 12

2 major routes for direct spread to the brain

Answer 12

foramen lacerum and ovale

Question 13

nerve V

Answer 13

trigeminal

Question 14

nerve VI

Answer 14

abducens

Question 15

Most common histology

Answer 15

SCC/epidermoid

Question 16

__% present distant mets

Answer 16

25

Question 17

Mets to __ is most common

Answer 17

bone then liver then lungs

Question 18

Lymphatic spread

Answer 18

node of rouvier to sup jugular and post cervical

Question 19

post cervical nodes

Answer 19

spinal accessory nodes

Question 20

node of rouvier

Answer 20

retropharyngeal

Question 21

__-__% have positive cervical nodes

Answer 21

75-80

Question 22

__-__% bilateral/contralateral have distant mets

Answer 22

40-70

Question 23

First clinical indication of lymphatic spread will tend to be __ __nodes

Answer 23

jugulo digastric

Question 24

___ is close to carotid so
inaccessible surgically therefore must be
included in nasopharynx treatment volume

Answer 24

node of rouvier/retropharyngeal

Question 25

__ is the first treatment of choice

Answer 25

rt

Question 26

Energy preference

Answer 26

lower: superficial structures higher: disadvantage due to separation, sensitivity, surrounding OAR

Question 27

sup border

Answer 27

2 cm margin beyond tumor, include base of skull and sphenoid sinuses

Question 28

post border

Answer 28

2 cm magin beyond mastoid process

Question 29

ant border

Answer 29

include post 1/3 maxillary sinus and nasal cavity

Question 30

inf border

Answer 30

thyroid notch, spare larynx

Question 31

treatment arrangement

Answer 31

opposed lateral field encompass tumor and nodal spread

Question 32

dose

Answer 32

5000 cGy

Question 33

CD boost

Answer 33

6500 cGy

Question 34

dose with lymphadenopathy

Answer 34

7000

Question 35

True/False: ANT Neck fields always incorporated in treating NP even with IMRT/3D with or without disease present

Answer 35

true

Question 36

T1 T2 dose

Answer 36

60-70 Gy

Question 37

T3 T4 dose

Answer 37

7000

Question 38

side effects of radiation short term

Answer 38

skin change, nausea, vomiting, fatigue, mouth sore, hoarseness, loss of taste

Question 39

long term rad side effect

Answer 39

xerostomia, tooth decay, bone damage, salivary gland damage, vision/hearing loss

Question 40

chemo drug for naso

Answer 40

cisplatin

Question 41

targeted therapy

Answer 41

erbitux

Question 42

sore throat begins __ week RT

Answer 42

2

Question 43

sore throat persists for __ post RT

Answer 43

1-2 months

Question 44

TSH levels should be monitored every ___ ___

Answer 44

6-12 months

Question 45

survival

Answer 45

45%

Question 46

nasal vestibule

Answer 46

entrance to cavity, skin hair sweat glands

Question 48

anatomy of nasal cavity

Answer 48

nasal vestibule limen nasi - beginning -paired nasal cavity sep by septal cartilage turbinates - bony folds

Question 49

symtoms of nasal cavity cancer

Answer 49

Obstruction * Minor intermittent bleeding * Sinus trouble/discharge * Orbital invasion

Question 50

spread of nasal cavity

Answer 50

direct, mid and inf turbinates

Question 51

lymph spread nasal cavity __-__% at time of diagnosis

Answer 51

10-15

Question 52

tx of nasla cavity

Answer 52

rt or surgery early lesion

Question 53

papilloma tx

Answer 53

surgery

Question 54

SCC or adeno tx nasal cavity

Answer 54

either or combo.. rt>surgery cosmesis

Question 55

nasal cavity dose

Answer 55

60-65 in 6-7 weeks

Question 56

survival nasal cavity

Answer 56

45-59%