14 Nasopharynx Cancer

Nasopharynx Cancer

7

THE GEC ESTROHANDBOOKOF BRACHYTHERAPY | Part II Clinical Practice Version 1 - 10/09/2019

Table 1. UICC/AJCC 8 th Edition Stage Classification System for Nasopharyngeal Cancer a

T0 b No appreciable primary tumour T1 Tumour confined to the nasopharynx, or extension to oropharynx and/or nasal cavity without parapharyngeal involvement T2 Tumour extends to the parapharyngeal space , and/or adjacent soft tissue involvement (medial and lateral pterygoid muscles, prevertebral muscles) T3 Tumour invades bony structures and/or paranasal sinuses T4 Tumour with intracranial extension and/or involvement of cranial nerves, hypopharynx, orbit, parotid gland, and/or extensive soft tissue infiltration beyond the lateral surface of the lateral pterygoid muscle N0 No cervical or retropharyngeal nodal metastases N1 Unilateral cervical nodal metastasis/es and/or unilateral or bilateral retropharyngeal nodal metastasis/es 6 cm or smaller, above the caudal border of the cricoid cartilage

T

N

N2 Bilateral cervical nodal metastases, 6 cm or smaller, above the caudal border of the cricoid cartilage N3 Unilateral or bilateral cervical nodal metastasis/es larger than >6 cm in greatest dimension and/or and/or extension below the caudal border of the cricoid cartilage

M0 No distant metastases M1 Presence of distant metastases

M

a Changes to previous 7 th edition highlighted in bold italics b In cases of EBER-positive metastatic cervical carcinoma of unknown primary for which the nasopharynx is the presumed origin

A

Figure 7. The afterloading mold is flexible in the longitudinal and axial planes. [Law, 2002]

B

Figure 8. The afterloading mould in-situ. A, Lateral view; B, Submento-occipital view. [Law, 2002]

Figure9.Paediatricendotrachealtubetechnique. 1A,paediatricendotracheal tubewithballoon cuff inflated and 1B, deflated; 2A, source carrier with cesium 137 slugs loaded and 2B, unloaded; 3, cesium 137 slugs; 4, pediatric rubber catheter occasionally used to guide endotracheal tube insertion; 5, 5-cc syringe; 6, local anaesthesia oropharyngeal spray; 7, cotton swabs; 8, local anaesthesia and nasal decongestant spray; 9, contrast for balloon filling. [Wang, 1987]