6.5.14: 14. Requirements for Effective Delivery for Primary Chemoradiation
- Page ID
- 18356
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- Primary CRT is an option mainly for selected T3 glottic cancers
- Not excessively bulky
- No cartilage destruction
- Patient factors
- Functional larynx: airway, swallowing, aspiration
- Likely to complete CRT treatment
- Fitness, age
- Social support / financial means
- Ability to cope with possible sequelae of CRT
- Aspiration
- Dysphagia
- Renal failure
- Hearing loss/ peripheral neuropathy
- Tracheostomy
- Hypothyroidism
- Total laryngectomy often a better option in low resource environments because CRT
- Complex, sophisticated, toxic treatment
- Requires complex supportive care, both during and following treatment
- Required package of care for favourable outcomes
- CT/MRI/PET imaging for planning and surveillance
- Modern radiation techniques
- Medical and social support during treatment
- Speech and swallowing therapy
- Access to PEG feeding (Short and/or long-term)
- Cancer surveillance (MRI / PET)
- Thyroid replacement therapy
- Complex salvage surgery including pedicled and free flaps