1.
Describe the cell cycle. Which phase is affected by chemotherapeutic agents?
2.
Give us a classification (according to mechanism of action) of common agents used in the treatment of squamous cell carcinoma?
3.
What is the mechanism of action of the metabolites: methotrexate and 5-fluorouracil? What are the common ENT and systemic side effects?
4.
What is the mechanism of action of cisplatin and carboplatin? What are the common ENT and systemic side effects?
5.
Define the terms “induction” “concurrent” “neoadjuvant” and “adjuvant” in relation to chemotherapy. What are the advantages and disadvantage of each of these approaches?
6.
What role does chemotherapy have in the management of head and neck cancer as a single modality treatment? Comment on the success rate in this situation?
7.
What role does combination chemotherapy have in the management of head and neck cancer treatment? Comment on the success rate in this situation?
8.
Discuss the role of neoadjuvant chemotherapy?
9.
Discuss the concept of “organ preservation” and which primary sites should be considered for such an approach?
10.
Review the VA Larynx study. What type of chemotherapy regimen was given? What was inclusion criteria? Compare cure rates between the surgical and non-surgical arm.
Reference(s):
Wolf, G. T., Fisher, S. G., Hong, W. K., Hillman, R., Spaulding, M., Laramore, G. E., … Henderson, W. G. (1991). Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. The New England Journal of Medicine, 324(24), 1685–1690.
11.
Describe side effects of chemotherapeutic agents used in treatment of H&N cancer? What measures exist to reduce side effects?
12.
Rationale for concurrent chemotherapy combined with radiation? Additional toxicity?
13.
What role do the Retinoids have in chemoprevention? What is their efficacy?
14.
Discuss the importance of nutrition in chemotherapy.
15.
Discuss new chemotherapeutic agents that show promise in the treatment of H&N cancer.
16.
Current data on intra-arterial chemotherapy for H&N cancer. What are the added risks and benefits?
17.
Review the Duke Chemoradiation Protocol. What type of chemotherapy regimen was given? What were inclusion criteria? What are the cure rates?
Reference(s):
Brizel, D. M., Albers, M. E., Fisher, S. R., Scher, R. L., Richtsmeier, W. J., Hars, V., … Prosnitz, L. R. (1998). Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. The New England Journal of Medicine, 338(25), 1798–1804.
18.
What role does Chemoradiation play in the prevention of distant metastasis?
19.
Discuss the chemotherapeutic treatment of rhabdomyosarcoma of the H&N.
20.
Describe the indications and value for chemotherapy in the post operative setting?
21.
What is the difference between chemotherapy and biologic treatments such as cetuximab?
22.
What evidence is there to support the use of biologic treatments in head and neck cancer care?