Current role of radiotherapy in the treatment of locally advanced laryngeal carcinomas

Cortesina, G; Stefani, A. De; Cavalot, A; Albera, Roberto; Rosso, Paola; Bussi, Mario

doi:10.1002/1096-9098(200005)74:1<79::aid-jso17>3.0.co;2-q

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…Even though the survival rates were comparable, the combined surgery and RT group was composed of subjects with more unfavorable prognostic factors. 23 Our data show that surgery alone, RT alone, and combined surgery and RT produce equivalent results in stage IV glottic cancer.…”

Section: Discussionmentioning

confidence: 53%

“…A more recent study of a large series of stages III and IV laryngeal carcinomas compared 163 (43%) patients who underwent surgery only with 217 (57%) patients who received surgery and postoperative RT. Even though the survival rates were comparable, the combined surgery and RT group was composed of subjects with more unfavorable prognostic factors 23 . Our data show that surgery alone, RT alone, and combined surgery and RT produce equivalent results in stage IV glottic cancer.…”

Section: Discussionmentioning

confidence: 99%

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Management of Stage IV Glottic Carcinoma: Therapeutic Outcomes

et al. 2004

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The five treatment modalities had statistically similar survival, recurrence, and complication rates. The overall 5-year DSS for patients with stage IV glottic carcinoma was 45%, and the OS was 39%. The cumulative disease-specific survival (CDSS) was 0.4770 with a mean survival of 10.1 years and a median survival of 3.9 years. Patients younger than age 55 years had better survival (DSS) than patients 56 years of age or older (P =.0002). Patients with early T stage had better survival than patients with more advanced T stage (P =.04). Tumor recurrence at the primary site (P =.0001) and in the neck (P =.014) and distant metastasis (P =.0001) had a deleterious effect on survival. Tumor recurrence was not related to treatment modality. Patients with clear margins of resection had a statistically significant improved survival (DSS and CDSS) compared with patients with close or involved margins (P =.0001). Post-treatment quality of life was not significantly related to treatment modality. Patients whose N0 neck was treated with observation and appropriate treatment for subsequent neck disease had statistically similar survival compared with patients whose N0 neck was treated prophylactically at the time of treatment of the primary. A minimum of 7 years of follow-up is recommended for early identification of recurrent disease, second primary tumors, and distant metastasis. None of the standard treatment modalities currently employed has a statistical advantage regarding survival, recurrence, complications, or quality of life.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Management of Stage IV Glottic Carcinoma: Therapeutic Outcomes

et al. 2004

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“…A similar opinion was presented by Wieczorek [ 12 ]. Also Cortesina et al [ 19 ], who used ECOG performance status classification, showed no prognostic role of this parameter.…”

Section: Discussionmentioning

confidence: 99%

Postoperative irradiation in patients with pT3-4N0 laryngeal cancer: results and prognostic factors

Skóra

Nowak-Sadzikowska

Mucha-Małecka

et al. 2014

Eur Arch Otorhinolaryngol

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Approximately 60 % of patients with locally advanced laryngeal cancer (LALC) treated primarily with surgery require adjuvant radiotherapy. In the available literature predominate series of patients were with pathologically confirmed node-positive status. Subgroups of pN0 patients with LALC are scarce. The aim of the study is to evaluate the efficacy of postoperative radiotherapy in patients with pathological stage T3-4N0M0 and identification of prognostic factors in this group. Between 1975 and 2005, 138 patients with squamous pT3-4N0 laryngeal cancer were irradiated postoperatively. Primary surgical treatment consisted of total laryngectomy and cervical lymphadenectomy. The median time between surgery and the implementation of radiotherapy was 56 days. The median total dose was 60 Gy (range 40–70 Gy). Five-year disease-free survival (DFS5) was achieved in 76 % of patients. Cancer recurrence was observed in 34 patients. In 28 (82 %) cases it was locoregional failure. DFS5 rates for pT3 and pT4 were 92 and 69 %, for margin status R0, R1 and R2 were 82, 72 and 67 %, respectively. The pharyngeal invasion was related to a decrease in DFS5 from 80 to 59 %. Postoperative irradiation in patients with pT3-4N0 LALC is an effective treatment method. The main reason of the failure is local recurrence. The following independent prognostic factors were identified in this group of patients: pT stage, surgical margin status and pharyngeal invasion.

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“…RT is often used with other treatment modalities. Postoperative RT is used in locally advanced laryngeal tumors to decrease recurrence [25]. It is also used with CT in a variety of organ preservation regimens described below [26].…”

Section: Overview Of Treatment Options For Laryngeal Cancermentioning

confidence: 99%

Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry

Rubinstein

Armstrong

2010

Lasers Med Sci

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Transoral laser microsurgery (TLM) is an emerging technique for the management of laryngeal and other head and neck malignancies. It is increasingly being used in place of traditional open surgery because of lower morbidity and improved organ preservation. Since the surgery is performed from the inside working outward as opposed to working from the outside in, there is less damage to the supporting structures that lie external to the tumor. Coupling the laser to a micromanipulator and a microscope allows precise tissue cutting and hemostasis; thereby improving visualization and precise ablation. The basic approach and principles of performing TLM, the devices currently in use, and the associated dosimetry parameters will be discussed. The benefits of using TLM over conventional surgery, common complications and the different settings used depending on the location of the tumor will also be discussed. Although the CO2 laser is the most versatile and the best-suited laser for TLM applications, a variety of lasers and different parameters are used in the treatment of laryngeal cancer. Improved instrumentation has lead to an increased utilization of TLM by head and neck cancer surgeons and has resulted in improved outcomes. Laser energy levels and spot size are adjusted to vary the precision of cutting and amount of hemostasis obtained.

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Current role of radiotherapy in the treatment of locally advanced laryngeal carcinomas

Abstract: The indications for combined treatment should be correlated with the prognostic factors to increase the survival rate of patients with stage III and IV laryngeal carcinoma.

Cited by 5 publications

References 27 publications

Management of Stage IV Glottic Carcinoma: Therapeutic Outcomes

Management of Stage IV Glottic Carcinoma: Therapeutic Outcomes

Postoperative irradiation in patients with pT3-4N0 laryngeal cancer: results and prognostic factors

Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry

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