Apollo Cancer Centre, Plot no, 251, Sainik School Rd, Bhubaneswar, Odisha

  • 73 year old male
  • Case of CA OROPHARYNX T3N2cM0
  • Biopsy – Mod diff sq cell Ca
  • Treated with concurrent RT/CT to a dose of 70Gy in 33# with IGRT-SIB technique in october 2016 along with 6cycles of concurrent chemo with carboplatin
  • Follow up CT scan in dec 2016 was NED
  • He was on regular follow up
  • CECT in Aug 2017- ill defined heterogenously enhancing nodular soft tissue lesion of size 2.3X1.9cm in left paravertebral
    region at the level of C1 vertebra
  • ?enlarged metastatic LN
  • PET-CT (AUG 2017) – enlarged FDG AVID partially necrotic LN in left prevertebral region of size 2.1X1.8cm with SUV 11.2
    • Patient was not willing for biopsy and IV chemotherapy
    • He was kept on Tab Geftinib 250mg OD
    • PET-CT(Jan 2018) – Stable disease with SUV 15
    • He was switched to Tab methotrexate
    • PET-CT(May 2018) – increase in size of the lesion to 2.8X2.4cm with SUV 15.6
    • Patient was not willing for any treatment
    • MRI BRAIN (DEC 2018)- 3.5X2.9X4.5cm lesion in the left parapharyngeal area eroding the left half of clivus/skull base
    • Plan – Palliative RT to a dose of 45Gy in 15# with IMRT technique in Feb 2019
    • FOLLOW UP PET-CT(APRIL 2019)- size of the lesion static with mild decrease in metabolic activity (SUV 15.6 decreased to SUV 9)