1. Chemotherapy

Indications:

Locally advanced head and neck squamous cell carcinoma (HNSCC) as part of concurrent chemoradiation.

Palliative treatment in recurrent/metastatic disease.

Neoadjuvant or adjuvant therapy in selected high-risk cases.

Expertise:

Administering agents like cisplatin (standard), carboplatin (for less fit patients), or cetuximab-based regimens.

Use of combination regimens like taxanes (docetaxel, paclitaxel), fluorouracil, or platinum-based therapies in advanced disease.

Managing toxicities such as nephrotoxicity, ototoxicity, mucositis, and hematological side effects.

 

2. Immunotherapy

Indications:

Recurrent or metastatic HNSCC with progression after platinum-based chemotherapy.

Expertise:

Administering immune checkpoint inhibitors like pembrolizumab (first-line for PD-L1 positive tumors) or nivolumab.

Monitoring for and managing immune-related adverse events (e.g., pneumonitis, colitis, thyroid dysfunction).

Evaluating treatment response using RECIST criteria and maintaining quality of life in palliative settings.

 

3. Radical Radiotherapy

Indications:

Definitive treatment of localized HNSCC (e.g., oropharynx, larynx, hypopharynx).

Post-operative radiotherapy for salivary gland malignancies with adverse pathological features (e.g., positive margins, perineural invasion).

Expertise:

Use of advanced techniques like IMRT, VMAT, and image-guided radiotherapy (IGRT) for precise delivery.

Application of adaptive radiotherapy strategies for tumor volume changes during treatment.

Managing acute toxicities like mucositis, xerostomia, and dermatitis, and addressing long-term side effects (e.g., fibrosis, swallowing dysfunction).

 

4. Concurrent Chemoradiotherapy

Indications:

Locally advanced HNSCC (e.g., oropharyngeal, nasopharyngeal).

Expertise:

Concurrent use of high-dose cisplatin with radiotherapy to enhance radiosensitivity.

Managing the synergistic toxicities of chemoradiotherapy, including severe mucositis, dysphagia, and weight loss.

Monitoring and ensuring adequate supportive care (e.g., feeding tube placement, hydration).

 

5. Adjuvant Radiotherapy

Indications:

Post-surgical cases with adverse features like extracapsular spread, positive margins, or perineural invasion.

Expertise:

Use of post-operative concurrent chemoradiotherapy for high-risk HNSCC.

Tailoring radiation fields to surgical bed and nodal areas at risk while sparing critical organs (e.g., parotid glands, spinal cord).

 

6. Palliative Radiotherapy

Indications:

Symptom relief in advanced or metastatic head and neck cancers (e.g., pain, bleeding, airway obstruction).

Expertise:

Administering short-course or hypo-fractionated regimens (e.g., 20 Gy in 5 fractions) for symptom relief.

Emergency radiotherapy for airway compromise or bleeding tumors.

Coordination with palliative care teams for holistic symptom management.

 

Additional Experience:

Salivary Gland Cancers:

Managing rare malignancies (e.g., adenoid cystic carcinoma, mucoepidermoid carcinoma) with post-operative radiotherapy or chemoradiation.

Applying systemic therapies for metastatic or high-risk cases, including targeted agents in clinical trials.

Multidisciplinary Tumor Boards:

Collaboration with surgeons, pathologists, and speech therapists for integrated care.

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Supportive Care:

Proactive management of treatment-related toxicities, including dental care, swallowing therapy, and nutritional support.

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Clinical Trials:

Participation in trials evaluating novel immunotherapy, chemotherapy, or combination strategies for head and neck cancers.

 

This range of expertise ensures high-quality, individualized care for head and neck cancer patients, addressing both curative and palliative needs.