ESMO Preceptorship Programme

Squamous Cell Carcinoma of Hypopharynx

MUHAMMAD ATIF MANSHA

Chief Resident, Radiation Oncology

Aga Khan University, Karachi, Pakistan

Ca Hypopharynx– Hong Kong – 13th-14th April 2019

ESMO PRECEPTORSHIP PROGRAMME

DISCLOSURE OF INTEREST

No Conflicts of Interest to Declare

ESMO PRECEPTORSHIP PROGRAMME

History & Physical Examination

� 32 years old, male

� No known comorbids

� Non smoker, non alcoholic

� Complaints – Progressive dysphagia for solid --- 3 months

– Occasional Cough --- 3 months

� Examination– General Physical exam: Pale

– Loco-regional exam: No neck nodes on palpation

– Systemic exam: Unremarkable

Investigations

� FODL

– Mass in right pyriform fossa

� Biopsy

– Poorly Differentiated Squamous Cell

Carcinoma

� CT Scan Head/Neck/Chest

– Soft tissue thickening involving right

pyriform fossa, 3.5 x 3 x 2.5 cm

– No neck lymphadenopathy

– No pulmonary metastasis

ESMO PRECEPTORSHIP PROGRAMME

Management

� Stage II cT2 N0 M0

� Feeding Gastrostomy

� Baseline labs

� 24 Hour Urinary Creatinine Clearance

� Definitive Concurrent Chemo Radiation

– IMRT

• 70 Gy in 35 Fr @ 2 Gy/Fr

– Cisplatin

• 100 mg/m2 every 3 weeks

� Weekly examination to assess toxicities &

response

ESMO PRECEPTORSHIP PROGRAMME

Follow Up

� 2 weeks

– CBC & Creatinine

– Physical examination

� 6 weeks

– FODL

• Edema seen in hypopharynx and larynx

� 8 weeks

– CT Scan Head/Neck

• No lesion seen in hypopharynx

� Patient is on monthly follow up for 2 years and doing well

ESMO Preceptorship Programme

Thank you for your attention!