Accelerated radiotherapy for advanced laryngeal cancer

“…Different studies reported results in combination with neck dissection and total laryngectomy as salvage treatment [14–16]. Local and loco-regional control rates range from 43 to 65 %, disease-free survival rates are reported between 40 and 68 %.…”

Section: Discussionmentioning

confidence: 99%

Organ preservation in T4a laryngeal cancer: is transoral laser microsurgery an option?

Canis

Ihler

Martin³

et al. 2013

Eur Arch Otorhinolaryngol

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The main objective of this study is to assess the feasibility of transoral laser microsurgery (TLM) in the treatment of T4a laryngeal cancer and to report the oncological and functional outcomes. This is a retrospective case-series study, held in a single-institute, academic tertiary referral center. Seventy-nine patients with previously untreated T4a glottic (n = 31, 39 %) or supraglottic laryngeal carcinoma (n = 48, 61 %) were included in this study. Five patients (6 %) were treated exclusively by TLM, 16 (20 %) had TLM and unilateral neck dissection, 27 (35 %) had TLM and bilateral neck dissection. Adjuvant (chemo)radiotherapy was additionally administered in 26 (33 %) cases following TLM and neck dissection, and in 5 (6 %) cases after TLM without neck dissection. The main outcome measures included organ preservation, local control, functional outcome, overall, recurrence-free, and disease-specific survival. The median follow-up period was 49 months, 5 year organ preservation rate and local control rate were 80.0 and 67.2 %, 5 year overall, recurrence-free and disease-specific survival were 55.8, 61.9 and 71.8 %. The 5 year overall survival rates were 62.5 % in pN0 cases and 57.2 % in cases with pN-positive neck disease. With respect to survival, these results are comparable to total laryngectomy, while being superior to primary (chemo)radiotherapy. TLM results in a low morbidity, rapid recovery and good function and can be a valid option for organ preserving surgery of pT4a glottic and supraglottic cancer.

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“…For early laryngeal cancer (glottic T 1 T 2 N 0 M 0 tumors) treated with radiotherapy in our institution, we have reported a 5-year locoregional control of 85% (1). The corresponding results for advanced laryngeal cancer are 49% for T 3 and 75% for T 4 tumors, respectively, with a larynx preservation rate for the surviving patients of 91% (2).…”

Section: Introductionmentioning

confidence: 70%

“…Forty-eight patients with stage III (18 patients) or IV (30 patients) disease received induction chemotherapy with 1 to 3 cycles of cisplatin and 5-fluorouracil. This treatment procedure has been described in detail in an earlier report from our institution (2).…”

Section: Methodsmentioning

confidence: 99%

Preradiotherapy Hemoglobin Level but not Microvessel Density Predicts Locoregional Control and Survival in Laryngeal Cancer Treated with Primary Radical Radiotherapy

Haugen¹,

Magnusson²,

Svensson

et al. 2004

Clinical Cancer Research

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Purpose: To evaluate the roles of preradiotherapy hemoglobin level and microvessel density (MVD) as predictive factors for tumor control and survival in patients with laryngeal cancer treated with primary radiotherapy.Experimental Design: Two hundred and fourteen patients with stage I-IV laryngeal cancer were included in the analysis. Patients were treated with once daily fractionated radiotherapy over 6.5 weeks or twice daily fractionated radiotherapy over 4.5 weeks up to total doses of 62 to 68 Gy. Preradiotherapy hemoglobin levels were obtained from patient journals, and pretreatment tumor biopsies were stained with CD34 antibody for the counting of microvessels. The prognostic implication of preradiotherapy hemoglobin level and MVD on tumor control and survival was tested.Results: Five-year locoregional control probability was 88.9% for patients with preradiotherapy hemoglobin levels >137.5 g/L (median) and 64.4% for patients with preradiotherapy hemoglobin levels <137.5 g/L (P ‫؍‬ 0.01). The corresponding figures for disease-free survival were 87.8 and 62.8% (P ‫؍‬ 0.007), respectively, and for overall survival 58.1 and 40.3% (P < 0.001), respectively.In multivariate analysis, tumor stage and preradiotherapy hemoglobin level were significant prognostic factors for locoregional control and disease-free survival, whereas tumor stage, preradiotherapy hemoglobin-level, gender, and age were significant prognostic factors for overall survival. No correlation was found between MVD and tumor control and survival.Conclusion: Preradiotherapy hemoglobin level, but not MVD, predicts locoregional control and survival in patients with laryngeal cancer treated with radiotherapy.

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Accelerated radiotherapy for advanced laryngeal cancer

Cited by 9 publications

References 25 publications

T4a laryngeal cancer survival: Retrospective institutional analysis and systematic review

T4a laryngeal cancer survival: Retrospective institutional analysis and systematic review

Organ preservation in T4a laryngeal cancer: is transoral laser microsurgery an option?

Preradiotherapy Hemoglobin Level but not Microvessel Density Predicts Locoregional Control and Survival in Laryngeal Cancer Treated with Primary Radical Radiotherapy

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