ESMO Preceptorship Programme

ESMO Preceptorship on Head and Neck Cancer 2019: Hong Kong, Hong Kong
- 13 Apr - 14 Apr 2019

Wiwiek Probowati
Trainee of Hematology and Medical Oncology, Dr. Sardjito Hospital, Yogyakarta,
Indonesia

Sequential Therapy in Residif Nasopharingeal Cancer

 Patient's data
 Patient characteristics : Male, 34 years old, ECOG PS 0
 Work : private
 Insurance : national health insurance
 Smoking status : non smoker
 Early complaint :
 Diagnosis : Nasopharing carcinoma T4N3aMx,
undifferentiated carcinoma WHO 3,axilary lymph node
metastase

ESMO PRECEPTORSHIP PROGRAMME

 Case history
May June June March September May
2016 2016 2016 2017 2017 2018
MSCT Ultrasonography
nasopharing: of mammae after
Early Pathology 1st line infiltrating of 2nd line Radiotherapy 2nd line chemo :
complain examination Chemotherapy maxilary sinus Chemotherapy 35 times Multiple nodal
dextra, metastase of left
enlargement of axilary,
NPC mass to
retropharingeal
space, nodal
metast of coli
sinistra

Bilateral Neck Undiferrentiated 1st line, 6 @2nd line Bone survey :

mass, painless, carcinoma(WH cycles chemotherapy, 6 osteolytic lesion
lymp node O 3) Chemotherapy cycles: multiple os
enlargement and : cisplatin and Gemcitabine and occipital and os
nasal discharge 5 Fluorouracil carboplatin 5 frontalis suspek
AUC skeletal
metastase.
FNAB nodal
axilary :
metastatic
undiferrentiated
nasopharing ca

ESMO PRECEPTORSHIP PROGRAMME

 Case history
May-
September November
2018 2018

Enlargement of axillary
lymph node and colli
Bone survey :
osteoclastic skeletal
metastase of os frontalis

3rd line chemotherapy 4th line chemotherapy :

: 6 cycles Paclitaxel- Docetaxel
Carboplatin

ESMO PRECEPTORSHIP PROGRAMME

ESMO PRECEPTORSHIP PROGRAMME
ESMO PRECEPTORSHIP PROGRAMME
ESMO PRECEPTORSHIP PROGRAMME
ESMO PRECEPTORSHIP PROGRAMME
ESMO Preceptorship Programme

Thank You
Acknowledgement

• All our Nasopharingeal cancer

patients
• dr. Johan Kurnianda, Sp.PD-
KHOM
• dr. Ibnu Purwanto, Sp.PD-
KHOM
• dr. Kartika Widayati, Sp.PD-
KHOM
• dr. Susanna Hilda Hutajulu,
Ph.D, Sp.PD-KHOM
• dr. Mardiah Suci Hadianti,
Ph.D, Sp.PD-KHOM
• All medical staff of Tulip
Cancer Clinic Dr. Sardjito
Hospital
• All research staff of Tulip
Cancer Clinic Dr. Sardjito
Hospital
• All trainee of hematology and
medical oncology Dr. Sardjito
Hospital