hematology -medical oncology trainee faculty of medicine ... · diagnosed august 2016, t4n2mo...
TRANSCRIPT
ESMO Preceptorship Programme
Metastatic Nasopharyngeal Carcinoma
at Multiple Sites
Dwi Wahyunianto HadisantosoHematology - Medical Oncology Trainee
Faculty of Medicine, Universitas Indonesia
Cipto Mangunkusumo Central Hospital Indonesia
Dharmais National Cancer Center Hospital
Undifferentiated carcinoma – Nasopharynx – 13th of April 2019
ESMO PRECEPTORSHIP PROGRAMME
DISCLOSURE OF INTEREST
� none
ESMO PRECEPTORSHIP PROGRAMME
Case Summary (1)
� Patient female, 27 y.o., came to clinics referred for
nasopharyngeal carcinoma that already spread to
her lungs and bones.
� Diagnosed August 2016, T4N2MO (st. IV A AJCC
VIII) she underwent chemoradiation (cisplatin
weekly 6 cycles, external irradiation daily 35
fractions) but not neoadjuvant nor adjuvant
chemotherapy.
ESMO PRECEPTORSHIP PROGRAMME
Case Summary (2)
� The program finished December 2016 and she
routinely check-up every 3 months.
� April 2018 the doctor found multiple nodules on her
lungs, suspected for metastasis and referred to us
in haematology and medical oncology division for
chemotherapy.
� We did restaging and found that it also had spread
to her bones and liver.
ESMO PRECEPTORSHIP PROGRAMME
Case Summary (3)
� We sent the patient to radiotherapy department for
weight bearing bones irradiation, and then platinum
and 5-FU combination chemotherapy + zoledronic
acid monthly were planned.
ESMO Preceptorship Programme
ESMO PRECEPTORSHIP PROGRAMME
� Pathology:
– Consistent with non-keratinized undifferentiated
carcinoma (gr. III WHO)
ESMO PRECEPTORSHIP PROGRAMME
09/08/2016 Diagnostic
ESMO PRECEPTORSHIP PROGRAMME
10/04/2017 After Chemoradiation
ESMO PRECEPTORSHIP PROGRAMME
02/02/2018 Thorax
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24/07/2018 CT Abdomen
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24/08/2018
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17-09-2018 Bone Scan