How would you manage a patient with synchronous locally advanced H&N (p16+) and locally advanced rectal adenocarcinoma?
If treating the H&N first, would you anticipate some effect of chemo on the rectal cancer? Would you include 5FU in the H&N chemo for better rectal cancer control? Would you consider short course rectal RT after chemo-RT to H&N?
Answer from: Radiation Oncologist at Community Practice
This is mostly a question of addition of chemotherapy (5FU with Cisplatin) and the timing of radiation therapy to the primaries. The dose of 5U if added for the H&N is not going to be of much effect for the rectal cancer since that would require a weekly 5-day PVI of 5FU. I actually contacted ou...
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Answer from: Radiation Oncologist at Academic Institution
If tethered I would go to 45 Gy with a boost to 50.4 Gy at 1.8 Gy per fraction. If fixed, 55.8 to 59.4. I agree with Robert re 5FU. You might try xeloda and cisplatin