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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!
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