4
Treatment
Figure 1B. Management of Stage IVC Disease
Stage IVC
Palliative neck/
Locoregional RT
a
Neck/
Locoregional RT
a
• Cytotoxics
• Clinical trials
Hospice/Palliative
care
Palliative neck/
Locoregional RT
a
• Focal palliative RT
a
• Palliative ablation/
Embolization
Focal lesion
control
• Systemic/
Chemotherapy
a
Intensity-modulated radiation therapy (IMRT) is preferred if possible.
Establish
Goals
Aggressive Rx
Initial
Therapy
Establish
Goals
Initial
Therapy
Supportive Care
