Prognostic factors in elderly patients with T1 glottic cancer treated with radiotherapy

Abstract

The aim of the study was the evaluation of the effectiveness of radiotherapy in elderly T1 glottic cancer patients and prognostic factors with particular focus on comorbidities. Five-year overall survival, disease-specific survival, and local control rates were 63%, 92%, and 93%, respectively. Multivariate analysis showed that the following factors had statistically significant impact on local relapse risk and cancer death risk: diabetes, underweight, and fraction dose of 2 Gy. High number of comorbidities, high CCI, and underweight negatively influenced overall survival. A retrospective analysis was performed in a group of 131 T1N0M0 glottic cancer patients aged 70 and above treated with irradiation at the National Institute of Oncology in Cracow between 1977 and 2007. In the analyzed group men prevailed (92%) of mean age of 74 years. Each patient was diagnosed with at least one comorbidity with the following comorbid conditions being most frequent: hypertension, ischemic heart disease, and chronic obstructive pulmonary disease. In the studied group, the effect of comorbidities on overall survival was evaluated using Charlson Comorbidity Index (CCI). Twenty five (19%) patients showed underweight. All patients were irradiated once daily, 5 days a week, to a total dose of 60–70 Gy with a fraction dose of 2 or 2.5 Gy. Radiotherapy is an effective treatment modality in elderly T1 glottic cancer patients. Diabetes as comorbidity, underweight, and conventional dose fractionation decrease the probability of curative effect of radiotherapy in this group of patients, while high number of comorbidities diminishes the probability of long-term survival.

Causes of death after laryngeal cancer diagnosis: A US population-based study

“…Research by Mucha-Małecka et al reported that the percentage of patients with T1N0M0 glottic cancer and ischemic heart disease was 44% in their cohort. The number of patients who had COPD was 44% as well [ 22 ]. Two other studies have reported a high prevalence of COPD among patients with LC [ 23 , 24 ].…”

Predictive value of ALDH1 and CD44 positivity for radiotherapy response and prognosis in early-stage glottic laryngeal squamous cell carcinoma

“…Diabetes, underweight, and conventional dose fractionation decrease the probability of curative effect of radiotherapy in elderly glottic cancer patients. A high number of comorbid diseases diminishes the probability of longterm survival in elderly glottic cancer patients [27]. For example, the overexpression of cycloxygenase-2 (COX-2), p53, epithelial cell adhesion molecule (EpCAM), hypoxia inducible factor 1α subunit, and carbonic anhydrase IX has been reported as a risk factor for a high local recurrence rate, and a high total microvessel perimeter per tumor area was a predictor of 337 optimized radiation therapy strategies for early GC [28,29,30,31].…”