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ESOCA

Dec 05, 20232 min read

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🌱來自: snippets

ESOCA

A+B+C

Esophageal ca, M/D SqCC, dx on, middle third, ?cm from incisor, cT3N2MX, stage IIIAB (LN: )

  • Initial presentation:
  • PET CT:
  • EGD:
  • ENT field negative for second primary tumor
  • Tolerate solid or liquid food
  • Treatment plan: preop/definitive CCRT
  • RT schedule: 4500cGy/25fx, started on 2018/00/00
  • 2010/00/00 Explain that esophageal cancer is a high risk disease, relative refractory to chemotherapy, surgery is the key role for this treatment. CCRT followed by OP may benefit patient with near 50% survival at year 5, but even definitive CCRT (without surgery) only provides patient with 15% survival at year 5. Emphases that there would be up to 25% chance refractory to CCRT, so that the following surgery would become impossible and the prognosis would be very bad.
  • Induction CCRT with P(60)F(600) on W1 and W5 or optional carboplatin (ACU 2) + taxol (50mg/m2) ON D1, 8, 15, 22, and 29
  • Set up feeding route: G-tube or NG @ Arrange W1 PF on the day of RT @ Arrange G-tube feeding on the day of admission @ Vascular assessment, nutritional assessment (consult nutritionist after G-tube setpup for feeding education), dental check, pharmacist education before chemotherapy.

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