Combined modality treatment of laryngeal squamous cell carcinoma

Abstract

Squamous cell carcinoma of the larynx is a major public health concern; it causes substantial morbidity and mortality, and arises chiefly as a result of tobacco and alcohol consumption. Early stage disease is best treated with radiation or surgery alone, but for patients with more locally advanced squamous cell carcinoma of the larynx, combined modality treatment has been shown to benefit selected patients, particularly when cisplatin-based chemotherapy and concurrent radiation therapy are employed, with or without altered fractionated radiation therapy. Substantial laryngectomy-associated quality-of-life decrements can be avoided in selected, potentially resectable patients with organ-sparing approaches, without sacrificing survival. Recently, trials have addressed the role of targeted systemic agents to the epidermal growth factor receptor, and other targets are under investigation. The addition of induction chemotherapy to concurrent chemoradiotherapy is a promising treatment strategy that warrants further evaluation, but has not yet emerged as a standard of care; the toxicity of such regimens must be balanced with the potential benefits on a case-by-case basis, and functional outcomes are often quite variable. Treatment planning, management and follow-up are complex, and thus should ideally be performed in a comprehensive, multidisciplinary fashion, in a center accustomed to a high volume of such cases. Future research directions are described herein.

Usefulness of ultrasonography in assessment of laryngeal carcinoma

“…It is much more challenging to diagnose laryngeal carcinoma by ultrasonography because this tumour is predominant in male adults [11,12], whereas the thyroid cartilage calcification occurs earlier and is more complete in males than in females [9]. However, according to the research of Chevallier et al [13], 50.0% or less calcification occurs in 40.0% of males, which makes satisfactory examination of all or part of the laryngeal structures in 92.1-98.0% of them possible.…”

Prognostic role of epidermal growth factor-like domain 7 protein expression in laryngeal squamous cell carcinoma

“…Following therapy for laryngeal SCC, local recurrence occurs in 5-25 per cent of tumour stage (T) 1 patients, and in 15-50 per cent of T 2 patients (with impaired vocal fold mobility). [3][4][5] The prognosis of laryngeal SCC patients is influenced by many factors, such as primary site, tumour stage, histological grade and lymph node metastasis. However, these factors are not sufficient to predict the tumour's prognosis.…”

Smoking Status and Pain Level Among Head and Neck Cancer Patients

“…In spite of this association, less than 20% of patients who smoked prior to their diagnosis quit after diagnosis; relapse rates are high 17,46,51. Moreover, strong evidence exists that ongoing tobacco use can have a negative effect on the outcomes of primary treatment3,14 and increase the risk of secondary primary tumors of the upper aerodigestive tract 17…”