Head and Neck SCC

• related: notes

Epidemiology

• head and neck cancer can be morbid but also can be cured more easily
• Incidence high due to HPV

• oral cavity: epithelial/respi track, more from smoking
• nasopharynx, lymph nodes: more from viral

Cases

• HPV related
• oropharynx
• surgery and radiation can cure head and neck cancer. Chemothrerapy can't
• Don't delay curative radiation by doing induction chemotherapy
• Adding chemotherapy to radiation improves chance of curing and mortality
• surgery if chemoradiation fails
• HPV+ improves overall survival and progression free survival

Treatment

• Cisplatin: best and also substantial SE

• Carboplatin: developed to reduce nausea/vomiting, ototoxicity, AKI. SE includes myelosuppression, higher risk of neutropenic fever, hypersensitivity reaction (risk accumulates especially after 8 doses)

• Cetuximab: targets regular EGFR that's more frequent in head and neck cancer. Can be used because do not need good kidney function

• Figure out where on picture pt falls