Concurrent Chemoradiotherapy With Docetaxel, Cisplatin, and 5-Fluorouracil for T3 N0 Glottic Carcinoma Without Vocal Cord Fixation

Abstract

Background/Aim: We retrospectively evaluated the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with docetaxel, cisplatin, and 5-fluorouracil (TPF) for T3 N0 glottic carcinoma without vocal cord fixation. Patients and Methods: Twenty-five patients underwent TPF-CCRT without elective nodal irradiaion (ENI). After the RT of 40 Gy, five patients (20%) without tumor regression underwent surgery. Others underwent RT with a median total dose of 66 Gy. Results: Of the five patients who underwent surgery after the RT of 40 Gy, two showed residual carcinoma pathologically and the other three were confirmed to have complete pathological response to the treatment. The 5-year local control rate was 87%. No patients exhibited regional failure. No acute toxicities of grade 5 or late toxicities ≥grade 3 were observed. Conclusion: TPF-CCRT provides excellent tumor control with acceptable toxicities. CCRT while omitting ENI is a reasonable approach for T3 N0 glottic carcinoma without vocal cord fixation.

The added value of radiomics in determining patient responsiveness to laryngeal preservation strategies

“…In T3N0 LC without vocal cord fixation, Toya et al [12] demonstrated that IC provides an excellent pathological response with acceptable toxicities; the problem is that there is toxic accumulation during IC in those patients with a poor response thus retarding radical treatment and worsening patient prognosis. Predicting with high precision response to IC is one of the most interesting fields of research when dealing with LC, since this could guide treatment strategies in locally advanced LC.…”

CT radiomics nomogram predicts pathological response after induced chemotherapy and overall survival in patients with advanced laryngeal cancer: A single-center retrospective study

“…Although total laryngectomy (TL) remains the gold standard for advanced LC, induction chemotherapy (IC) with or without radiotherapy as a standard approach for larynx preservation commonly recommends addressing advanced LC before TL in the current NCCN guidelines (4); it achieves better larynx preservation than immediate surgery without considering overall survival (OS) (5,6). Toya et al (7) reported that IC provides excellent pathological response (PR) with acceptable toxicities in T3N0 glottic carcinoma without vocal cord fixation (7); however, there is a risk of toxic accumulation during IC in patients with poor PR. Thus, it is important to predict the PR with high precision to guide appropriate treatment strategies.…”