H&N Cancer :
Operable -->surgery (except larynx where organ preservative chemo-rad preferred)
Non Operable--> Chemo-Rad (Cisplatin or cetuxinmab with radiation)
Metastatic--> TPF (Cisplatin, 5 fu, texotere) chemo or similar combination
Nasopharyngeal respond well to chemo
LUNG CANCER:
Small Cell
Deal with brain mets first with gamma knife or whole brain rads before dealing with rest of cancer
Limited stage (only one lung involved/no pleural eff/whole tumer can come under radiation port) cispLatin/etoposide x concurrent radiation to lung followed by prophylactic brain radiation
Extended stage: Cisplatin/etopside x 6 cycle followed by prophylactic brain radiation followed by intermitted maintenace or clinical trial
Non Small Cell Lung Cancer:
stage 1a, 1b (<4cm) surgery or defenite radiation
Higher stage:
Adeno: 1b to 111b operable: surgery follwed by adjuvent chemo with cisplatin (can be replaced with carbo in renal failure) plus alimta or nevalbine
Adeno Stage 111 non operable: chemo/xrt defenite
Adeno: Non operable or stage 4: cisplatin plus alimta 4-6 cycle followed by maintenance alimta or taxane
Adeno: with EGFR mutation: tarceva po happyyyy
Squamous and other NSCLC: 1a, 1 b (<4cm) surgery or defenot rads
Squamous and other NSCLC: 1b-111b operable: surgery followed by adjuvent cisplatin (any of these: nevalbine, gem, taxane)
Squamous and other NSCLC Stage 111 non operable: chemo/xrt defenit
Squamous and other NSCLC Stage 4: cisplatin (any of these: nevalbine, gem, taxane) or avastin carbo, taxol combination followed by taxane maintenance
