Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO...
Transcript of Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO...
![Page 1: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/1.jpg)
ESMO Preceptorship Programme
Metastatic Nasopharyngeal Carcinoma
at Multiple Sites
Dwi Wahyunianto HadisantosoHematology - Medical Oncology Trainee
Faculty of Medicine, Universitas Indonesia
Cipto Mangunkusumo Central Hospital Indonesia
Dharmais National Cancer Center Hospital
Undifferentiated carcinoma – Nasopharynx – 13th of April 2019
![Page 2: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/2.jpg)
ESMO PRECEPTORSHIP PROGRAMME
DISCLOSURE OF INTEREST
� none
![Page 3: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/3.jpg)
ESMO PRECEPTORSHIP PROGRAMME
Case Summary (1)
� Patient female, 27 y.o., came to clinics referred for
nasopharyngeal carcinoma that already spread to
her lungs and bones.
� Diagnosed August 2016, T4N2MO (st. IV A AJCC
VIII) she underwent chemoradiation (cisplatin
weekly 6 cycles, external irradiation daily 35
fractions) but not neoadjuvant nor adjuvant
chemotherapy.
![Page 4: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/4.jpg)
ESMO PRECEPTORSHIP PROGRAMME
Case Summary (2)
� The program finished December 2016 and she
routinely check-up every 3 months.
� April 2018 the doctor found multiple nodules on her
lungs, suspected for metastasis and referred to us
in haematology and medical oncology division for
chemotherapy.
� We did restaging and found that it also had spread
to her bones and liver.
![Page 5: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/5.jpg)
ESMO PRECEPTORSHIP PROGRAMME
Case Summary (3)
� We sent the patient to radiotherapy department for
weight bearing bones irradiation, and then platinum
and 5-FU combination chemotherapy + zoledronic
acid monthly were planned.
![Page 6: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/6.jpg)
ESMO Preceptorship Programme
![Page 7: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/7.jpg)
ESMO PRECEPTORSHIP PROGRAMME
� Pathology:
– Consistent with non-keratinized undifferentiated
carcinoma (gr. III WHO)
![Page 8: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/8.jpg)
ESMO PRECEPTORSHIP PROGRAMME
09/08/2016 Diagnostic
![Page 9: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/9.jpg)
ESMO PRECEPTORSHIP PROGRAMME
10/04/2017 After Chemoradiation
![Page 10: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/10.jpg)
ESMO PRECEPTORSHIP PROGRAMME
02/02/2018 Thorax
![Page 11: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/11.jpg)
ESMO PRECEPTORSHIP PROGRAMME
24/07/2018 CT Abdomen
![Page 12: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/12.jpg)
ESMO PRECEPTORSHIP PROGRAMME
24/08/2018
![Page 13: Hematology -Medical Oncology Trainee Faculty of Medicine ... · Diagnosed August 2016, T4N2MO (st.IV A AJCC VIII) she underwent chemoradiation (cisplatin weekly 6 cycles, external](https://reader033.fdocuments.us/reader033/viewer/2022060810/608eca1a0c74b7124533579f/html5/thumbnails/13.jpg)
ESMO PRECEPTORSHIP PROGRAMME
17-09-2018 Bone Scan