Changes in treatment of advanced laryngeal cancer 1985‐2001

Chen, Amy Y.; Schrag, Nicole M.; Hao, Yongping; Flanders, W. Dana; Kepner, James L.; Stewart, Andrew K.; Ward, Elizabeth C.

doi:10.1016/j.otohns.2006.07.012

Cited by 81 publications

(97 citation statements)

References 6 publications

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“…17 Simultaneously, advances in RT were made, and IMRT, with its unmatched conformality and lower toxicity, demonstrably improved survival outcomes in patients with head and neck cancer. 14 Consequently, the current standard of care for patients with T3 laryngeal cancers who have good laryngeal and swallowing function is laryngeal preservation surgery or CRT with IMRT.…”

Section: Discussionmentioning

confidence: 99%

Erratum

2017

Head & Neck

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Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches. Head Neck 2016; 38(12):1739-1751. DOI 10.1002/ hed.24532.The authors have brought to our attention that during production the acronym "LP-PORT" was incorrectly inserted in place of the correct acronym "TL-PORT" (total laryngectomy with post-operative radiotherapy) in the Results and the Discussion sections. The publisher regrets this error. The entire revised article follows. ABSTRACT: Background. The purpose of this study was to evaluate the long-term outcomes after initial definitive or adjuvant radiotherapy (RT) for T3 laryngeal cancers. Methods. We reviewed 412 patients treated for T3 laryngeal squamous cell cancer from 1985 to 2011. Results. The 10-year overall survival (OS) was 35%; disease-specificsurvival (DSS) was 61%; locoregional control was 76%; and freedom from distant metastasis was 83%. Chemotherapy, age, performance status <2, node-negative status, and glottic subsite were associated with improved survival (all p < .03). Larynx preservation with induction and/ or concurrent chemoradiotherapy (LP-CRT) had better laryngectomy-free survival than RT alone (LP-RT; hazard ratio [HR] 5 0.62; 95% confidence interval [CI] 5 0.47-0.81; p 5 .0005); 10-year laryngectomyfree survival rates of the LP-CRT cohort (37%) were higher than those of the LP-RT cohort (18%). The 5-year DSS and OS rates of the LP-CRT cohort (79% and 67%) were better after total laryngectomy with postoperative RT (TL-PORT; 61% and 50%) and LP-RT (64% and 46%; p < .006 for all). Conclusion. In patients with T3 laryngeal cancers, LP-CRT provides better functional, oncologic, and survival outcomes than historical TL-PORT or LP-RT does.

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Section: Discussionmentioning

confidence: 99%

Erratum

2017

Head & Neck

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“…They included 12 of the 13 papers in Clarke and Loudon's review, [97][98][99][100][101][102]104,105,[108][109][110][111] and an additional 21 papers, 103,106,107,[112][113][114][115][116][117][118][119][120][121][122][123][124][125][126][127][128][129] including 10 published since the beginning of 2009 [114][115][116][117][118][119]121,123,126,128 when Clarke and Loudon conducted their search. We had a broader remit and conducted our search in a different way, but we were able to benefit from knowing which papers they had included and ensuring that our search terms captured as many of these papers as possible.…”

Section: Chaptermentioning

confidence: 99%

“…The 21 papers in this group included 12 from Clarke and Loudon, [97][98][99][100][101][102]104,105,[108][109][110][111] and a further nine papers consisting of four published since the Clarke and Loudon search, [114][115][116][117] and others that were the result of our wider inclusion criteria. Some of the additional papers fell into both categories.…”

Section: By-product Papersmentioning

confidence: 99%

“…prior research involvement in general, nor membership of the network, but not in the specific trial, made an impact. Some differences between the hurdles needed to cross to implement the respective drug and behavioural treatments might explain the differences 'comparatively farther along the "S-shaped curve" that characterises the diffusion of innovations (Rogers, 1995 Of the 21 papers in the by-product category described above, 17 97,99,[101][102][103][104][105]107,108,[110][111][112][113][114][115][116][117] produced positive findings about the link between research engagement and improved performance. We classified seven of the positive studies as important to our review.…”

Section: By-product Papersmentioning

confidence: 99%

“…102,110,111,113,[114][115][116] Four papers 98,100,106,109 produced negative, or mixed/negative, findings and we classified two of these as important. 98,109 Most of the 17 papers 97,99,[101][102][103][104][105]107,108,[110][111][112][113][114][115][116][117] reporting positive findings described measurable improvements in the processes of care thought to lead to better outcomes, rather than better health outcomes per se. Just six studies reported better health outcomes, three of which had been included in Clarke and Loudon's review (du Bois et al, 102 Jha et al 105 and Majumdar et al…”

Section: By-product Papersmentioning

confidence: 99%

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Engagement in research: an innovative three-stage review of the benefits for health-care performance

Hanney

Boaz

Jones

et al. 2013

Health Services and Delivery Research

154

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BackgroundThere is a widely held assumption that research engagement improves health-care performance at various levels, but little direct empirical evidence.ObjectivesTo conduct a theoretically and empirically grounded synthesis to map and explore plausible mechanisms through which research engagement might improve health services performance. A review of the effects on patients of their health-care practitioner's or institution's participation in clinical trials was published after submission of the proposal for this review. It identified only 13 relevant papers and, overall, suggested that the evidence that research engagement improves health-care performance was less strong than some thought. We aimed to meet the need for a wider review.MethodsAn hourglass review was developed, consisting of three stages: (1) a planning and mapping stage; (2) a focused review concentrating on the core question of whether or not research engagement improves health care; and (3) a wider (but less systematic) review of papers identified during the two earlier stages. Studies were included inthe focused review if the concept of ‘engagementinresearch’ was an input and some measure of ‘performance’ an output. The search strategy covered the period 1990 to March 2012. MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and other relevant databases were searched. A total of 10,239 papers were identified through the database searches, and 159 from other sources. A further relevance and quality check on 473 papers was undertaken, and identified 33 papers for inclusion in the review. A standard meta-analysis was not possible on the heterogeneous mix of papers in the focused review. Therefore an explanatory matrix was developed to help characterise the circumstances in which research engagement might improve health-care performance and the mechanisms that might be at work, identifying two main dimensions along which to categorise the studies:the degree of intentionalityandthe scope of the impact.ResultsOf the 33 papers in the focused review, 28 were positive (of which six were positive/mixed) in relation to the question of whether or not research engagement improves health-care performance. Five papers were negative (of which two were negative/mixed). Seven out of 28 positive papers reported some improvement in health outcomes. For the rest, the improved care took the form of improved processes of care. Nine positive papers were at a clinician level and 19 at an institutional level. The wider review demonstrated, for example, how collaborative and action research can encourage some progress along the pathway from research engagement towards improved health-care performance. There is also evidence that organisations in which the research function is fully integrated into the organisational structure out-perform other organisations that pay less formal heed to research and its outputs. The focused and wider reviews identified the diversity in the mechanisms through which research engagement might improve health care: there are many circumstances and mechanisms at work, more than one mechanism is often operative, and the evidence available for each one is limited.LimitationsTo address the complexities of this evidence synthesis of research we needed to spend significant time mapping the literature, and narrowed the research question to make it feasible. We excluded many potentially relevant papers (though we partially addressed this by conducting a wider additional synthesis). Studies assessing the impact made on clinician behaviour by small, locally conducted pieces of research could be difficult to interpret without full knowledge of the context.ConclusionsDrawing on the focused and wider reviews, it is suggested that when clinicians and health-care organisations engage in research there is the likelihood of a positive impact on health-care performance. Organisations that have deliberately integrated the research function into organisational structures demonstrate how research engagement can, among other factors, contribute to improved health-care performance. Further explorations are required of research networks and schemes to promote the engagement of clinicians and managers in research. Detailed observational research focusing on research engagement within organisations would build up an understanding of mechanisms.Study registrationPROSPERO: CRD42012001990.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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