Management of Head and Neck Patients Presenting at Diagnosis with a Synchronous Cancer in Another Anatomic Site

and 3 were 689.0%, 9.6%, 1.4%, and 0; anemia of Grade 0, 1, 2, and 3 were 97.2%, 0, 2.8%, and 0, respectively. The remission rates (CR+PR) of primary tumor and positive lymph nodeswere 91.8%and 98.1%. Fourmonthsafter radiation therapy xerostomia of Grade 0, 1, and 2 were 4.2%, 87.5%, and 8.3%, respectively. One-year relapse free survival (RFS) is 95.6%, distant metastasis free survival (DMFS) is 97.2%, and overall survival (OS) is 94.8%. Conclusions: The incidence of severe acute toxicities and late xerostomia is relatively minor for NPC patients treated with TomoTherapy which presents great advantages from both planning and delivery aspects. For NPC with large tumor volume and nodal involvement, Tomotherapy presents clinical advantages compared to conventional delivery methods. Long-term clinical outcome for these patients are under further investigation.