Intensity-Modulated Radiation Therapy for Early-Stage Squamous Cell Carcinoma of the Glottic Larynx: A Systematic Review and Meta-Analysis

Razavian, Niema; D’Agostino, Ralph B.; Shenker, R.F.; Hughes, Ryan T.

doi:10.1016/j.ijrobp.2023.04.035

Cited by 8 publications

(2 citation statements)

References 61 publications

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“…Interestingly though, despite some studies suggesting excellent outcomes of IMRT for early-stage glottic SCC treatment, comparison studies between IMRT and 3D-CRT suggest similar rather than superior outcomes for IMRT. 3,5,6,10 However, it is important to consider the theoretical long-term benefits to the spared carotid artery in IMRT that have not yet been definitively elucidated clinically. 10 Nevertheless, RT-whether it be IMRT, 3D-CRT, or another method-remains a commonly utilized and effective treatment option for T1 glottic SCC patients.…”

Section: Discussionmentioning

confidence: 99%

“…Modern radiotherapy options, such as 3D-conformal radiotherapy (3D-CRT) and intensitymodulated radiation therapy (IMRT), have been shown to be comparatively effective in treating early-stage glottic cancers. [3][4][5][6] There is still debate on whether surgery or RT is superior as the first-line therapy for patients with T1 glottic cancers. Most studies evaluating these two options conclude that either surgery or RT as single-modality treatments offer comparatively successful results for these patients based on local control, distant metastasis rates, second primary tumor rates, disease-free survival, laryngectomy-free survival, overall survival, GRBAS (grade, roughness, breathiness, asthenia, and strain) scores, Cepstral Spectral Index of Dysphonia scores, and subjective patient-reported voice outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Patterns of Care for T1 Glottic Squamous Cell Carcinomas from 2004–2020

Malik,

Jacobs,

Fereydooni

et al. 2024

The Laryngoscope

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Objective(s)Describe recent national trends in overall treatment modalities for T1 glottic squamous cell carcinomas (SCC), and identify factors associated with treatment regimens.MethodsNational Cancer Database from 2004–2020 was queried for all patients with glottic cT1N0M0 SCC. Treatment patterns over time were analyzed using the Cochran‐Armitage test for trend. Multivariable logistic regressions were used to determine the factors associated with treatment regimens.ResultsOf the 22,414 patients identified, most patients received RT only (57%), 21% received surgery only, and 22% received dual‐modality treatment (“over‐treatment”). Over the time period, there was a decreasing trend in rates of over‐treatment for T1 glottic SCC (p < 0.001) and an increasing trend in surgery only (p < 0.001). Treatment in 2016–2018 (OR: 1.168 [1.004 to 1.359]), 2013–2015 (OR: 1.419 [1.221 to 1.648]), 2010–2012 (OR: 1.611 [1.388 to 1.871]), 2007–2009 (OR: 1.682 [1.450 to 1.951]), or 2004–2006 (OR: 1.795 [1.548 to 2.081]) versus 2019–2020 was associated with greater likelihood of over‐treatment. T1b tumors were less likely to be over‐treated (OR: 0.795 [0.707 to 0.894]) versus T1a tumors, and less likely to receive surgery first (OR: 0.536 [0.485 to 0.592]) versus T1a tumors.ConclusionOver‐treatment for T1 glottic SCC has been declining, with increasing rates of surgery only. Year of treatment was significantly associated with the receipt of dual‐modality treatment. Finally, patients with T1b disease were more likely to receive RT as the first and only treatment.Level of Evidence3 Laryngoscope, 2024

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patterns of Care for T1 Glottic Squamous Cell Carcinomas from 2004–2020

Malik,

Jacobs,

Fereydooni

et al. 2024

The Laryngoscope

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Use of the 445‐nm Blue Laser for Management of Early Glottic Carcinoma: Preliminary 1‐Year Results

Rosow,

Keidar,

Pasick

et al. 2024

The Laryngoscope

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ObjectiveTo analyze oncological efficacy and voice outcomes of the 445‐nm blue laser (BL) in the treatment of early glottic carcinoma and compare results with the 532‐nm potassium‐titanyl‐phosphate (KTP) laser.Study DesignSingle institution, retrospective chart review.MethodsAll patients who underwent microlaryngoscopic KTP or BL laser excision of early glottic carcinoma from 2018 to the present day with at least 1‐year follow‐up were included. Primary and recurrent disease, including radiation and surgical failures, were included. Demographic data, voice outcomes and oncologic outcomes were compared between the two laser groups.ResultsForty‐nine patients met the inclusion criteria for the BL group and 88 for the KTP group, with average follow‐up of 635 and 1236 days, respectively. Oncologic outcomes were not significantly different, with disease‐specific survival rates of 95.9% for BL and 100% for KTP (p = 0.13), organ preservation rates of 98.0% for BL and 95.6% for KTP (p = 0.39), and local control rates of 93.9% for BL and 92.1% for KTP (p = 0.81). Both BL and KTP groups showed significant improvement in CAPE‐V (p = 0.04, 0.006 respectively) and VHI‐10 scores (p = 0.003, <0.00001) following surgery.ConclusionsPhotoangiolytic removal of early glottic carcinoma with BL appears to be equally safe and effective as with KTP laser at minimum one‐year follow‐up, and with excellent voice outcomes. Additional study will be warranted over time to assess long‐term outcomes in BL patients.Level of Evidence3 Laryngoscope, 2024

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In Regard to Razavian et al.

Takiar,

Beadle

2023

International Journal of Radiation Oncology*Biology*Physics

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Intensity-Modulated Radiation Therapy for Early-Stage Squamous Cell Carcinoma of the Glottic Larynx: A Systematic Review and Meta-Analysis

Cited by 8 publications

References 61 publications

Patterns of Care for T1 Glottic Squamous Cell Carcinomas from 2004–2020

Patterns of Care for T1 Glottic Squamous Cell Carcinomas from 2004–2020

Use of the 445‐nm Blue Laser for Management of Early Glottic Carcinoma: Preliminary 1‐Year Results

In Regard to Razavian et al.

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