Head and Neck Cancers   

If advanced stage do you follow same guidelines as Scc? Do you use same Cth regimen? Role of total laryngectomy ? 

Would gross ENE or R1 resection trigger you to consider adding chemo? If so, do you use weekly cisplatin or cisplatin/etoposide?

In addition to TSH suppression, would you opt for RAI, targeted treatment based off NGS, or lenvatinib?

Are you employing more or less primary chemoRT v. surgery for some cancers? Are you dose de-escalating? What are issues radiation oncologists should b...

Would you consider it for a patient with good PS but with limited metastatic disease? What dose fractionation would you prefer?

How do you decide on other chemo regimen? (Dosing, frequency, carboplatin based, non-platinum based etc.) Would you use Cetuximab? Altered fractiona...

Is there data to support every 3 week dosage v. weekly?

Does the availability of first line checkpoint inhibitor therapy affect your treatment decision? 

Do different modalities of imaging (PET vs MRI vs CT) help you to distinguish one etiology versus the others? What about other clinical characteristic...

Aside from smoking cessation, what interventions have you found useful to manage patients with chronic symptomatic laryngeal edema? Steroids seem to b...

How would you approach a patient who is receiving chemoRT but has confirmed COVID-19 with minor symptoms, as breaking treatment for 2 weeks quarantine...

Is there data for weekly versus every 3 week cisplatin in this setting?

For example, for a patient that has been through multiple disfiguring surgeries and radiation and wants to delay time to next resection.

Do you start with TKIs or platinums?

Specifically with reference to rural settings where the logistics of early in the week delivery may be more challenging.

-The data on induction for adult H&N ca has been mixed (excluded NPX) but recent data suggest a benefit for adult NPX. -Given that this is standa...

Patient initially was started on cetuximab due to renal insufficiency of unclear chronicity (uncontrolled hypertension) that significantly improved du...

Although platinum/5-FU was used in KEYNOTE-048, can an alternative like carbo/paclitaxel be given since it may be better tolerated?

Given not surgical candidate and within 1 year of chemoRT (recurrence within RT field), would you repeat chemoRT, RT alone, or systemic therapy alone?...

NCCN suggests either concurrent chemoRT or induction chemotherapy in these patients.

Does your approach differ by EBV status?  

Would you recommend surgery, definitive chemoRT, or chemotherapy alone?

Aggressive histology with tall cell variant papillary thyroid carcinoma that's progressed 2 months after RAI and while on TSH suppression, without tra...

Some ENTs advocate for a neck dissection as a way to avoid chemotherapy if there is a high chance there is no ECE. This is without removing the primar...

What clinical criteria would make you prefer TORS as the initial treatment approach?  

Would you proceed with induction chemotherapy (eg TPF or cis/gem) to downstage or neoadjuvant chemoRT? Would your approach be different if there is or...

Have you seen RAI or lenvatinib be efficacious for locally advanced disease — allowing for better surgical outcomes?  Do you utilize EBRT?

How do you decide?  Do the results of recently published phase III data in the Lancet Oncology (Sun et al, Sept 2016) influence your decisio...

If neck dissection was done, do you offer adjuvant chemo and/or XRT?

Do you have a time threshold for re-challenge with platinum?  Of note, Checkmate 141 defined platinum refractory as relapse within 6 months of pl...

For the first treatment day (during combined chemo/XRT courses), is it ok to give XRT first then send the patient for chemo or should the chemo be giv...

Do you ever start radiation +/- 24-48 hrs from C1D1 for chemotherapy due to logistical barriers? Do you prefer chemotherapy to start at beginning of ...

Is concurrent chemotherapy necessary for these patients?

Does papillary histology influence your decisions regarding surgery, chemo, radiation dose or nodal coverage?

Routinely? Only with oropharyngeal cancer etc.? Given that low expression of EGFR subset did better, do you believe there is a true benefit in cetuxim...

Would you offer locoregional control alone, locoregional with adjuvant therapy, or active surveillance?

Which of the systemic options would you give concurrently with radiation therapy in the adjuvant setting? According to NCCN guidelines, high dose...

In the context of the new staging systems and possible differences of HPV mediated vs smoking mediated oropharynx SCC, would you ever not recommend co...

If you recommend or use induction chemotherapy, what is your preferred chemotherapy regimen?

If not, what is your thyroid hormone withdrawal protocol?  If so, would you still treat a patient with possibly metastatic disease?  

Do you typically use 5-FU/cisplatin/cetuximab, or do you prefer other options?

If so, when? Although anemia is associated with worse local control in HN cancer, I don't know of any data that shows that blood transfusions can help...

Do HPV and/or PD-L1 status influence your decision making? 

Our ENT surgeons often tell patients with evidence of matted nodes on imaging that their swallowing function will be much worse after 70Gy as compared...

Definitive chemoradiation vs. surgery followed by adjuvant radiation/chemoradiation?

Even though we do not have the best data on the use of induction chemotherapy, what are current practices?