Radiation therapy in early carcinoma of the glottic larynx T1NOMO

Medini, Eitan; Medini, Allen; Gapany, M.; Levitt, Seymour H.

doi:10.1016/s0360-3016(96)00431-2

Cited by 16 publications

(15 citation statements)

References 6 publications

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“…As expected, higher T stage (T2) in our study also predicted a relative risk of about 1.5 times for increased local recurrence (p = 0.001) and poorer 5-year overall survival (p < 0.003). Several other studies have demonstrated similar outcomes for higher T stage laryngeal disease [21–23]. …”

Section: Discussionmentioning

confidence: 60%

BCCIP as a prognostic marker for radiotherapy of laryngeal cancer

Rewari¹,

Lu²,

Parikh³

et al. 2009

Radiotherapy and Oncology

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Background Recent studies have shown that BCCIP (BRCA2 & CDKN1A interacting protein) is essential for maintaining the transactivation activity of wild type p53. We analyzed the expression of BCCIP and p53 in a cohort of laryngeal cancer treated with radiotherapy and assessed whether BCCIP and p53, alone or in combination, would correlate with local control and overall survival. Methods One hundred twenty-three patients treated between 1975 and 2000 for early stage (stage I & II) squamous cell carcinoma of the larynx were included in the study. Treatment consisted of radiation therapy (RT) with standard fields and fractionation to a median dose of 66 GY. Tissue was collected from pre-RT biopsies and constructed in a tissue microarray and BCCIP and p53 expression was determined using immunohistochemistry. Results Loss of expression of BCCIP in combination with normal p53 (negative p53 staining) was associated with local recurrence (RR 2.04; 95% CI 0.99–4.56, p=0.05) and poor overall survival (RR 2.09; 95% CI 1.21–4.00, p=0.008) compared to patients who did express BCCIP. Expression of BCCIP or p53 alone was not found to be independently associated with benefits in local control or overall survival. Conclusions This study provides clinical evidence that BCCIP contributes to outcomes in patients with laryngeal cancer treated with RT. This benefit may be a result of increased radiosensitivity in patients who have functional BCCIP and p53. These data may be used to identify sub-groups of laryngeal cancer patients who are more likely to be cured with radiotherapy.

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Section: Discussionmentioning

confidence: 60%

BCCIP as a prognostic marker for radiotherapy of laryngeal cancer

Rewari¹,

Lu²,

Parikh³

et al. 2009

Radiotherapy and Oncology

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“…Several other studies have demonstrated similar outcomes for higher T-classification laryngeal disease. 8,29,30 Although this is a relatively large series of patients treated uniformly for early stage laryngeal cancer, the number of events was relatively low. A significant limitation of the current study is that information on actual cause of death was limited.…”

Section: Discussionmentioning

confidence: 95%

“…4,6 Nevertheless, overall control of disease may reach 90% to 100% if surgical salvage is performed. 7,8 Currently available clinicopathologic markers, such as extension of disease into nearby structures, lymph node status, and positive surgical margins, are suitable for predicting prognosis. 9 Molecular markers have the potential to consistently select high-risk patients and label biologically aggressive disease.…”

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confidence: 99%

Prognostic significance of vascular endothelial growth factor protein levels in T1‐2 N0 laryngeal cancer treated with primary radiation therapy

Yang¹,

Haffty²

2006

Cancer

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BACKGROUND.The purpose of this study was to assess the prognostic value of vascular endothelial growth factor protein levels in a large cohort of patients with T1‐T2 N0 laryngeal cancer treated with primary radiation therapy (XRT).METHODS.Primary tumor specimens from a cohort of 123 patients with T1‐T2 N0 laryngeal cancer treated with XRT between 1975 and 2000 were constructed into a tissue microarray. Clinical prognostic factors included age, sex, T classification, and tumor subsite. Molecular prognostic factors included vascular endothelial growth factor, epidermal growth factor receptor, and p53 expression, determined by using immunohistochemistry on tissue microarrays. The association between vascular endothelial growth factor status, covariables, and outcome was assessed.RESULTS.With a median follow‐up of 9.9 years, 32 (26%) were diagnosed with local relapse (5‐year local relapse‐free rate, 70.4%). T2 tumor stage (31.7%) was a significant predictor of local relapse (relative risk [RR], 1.71; 95% confidence interval [CI], 1.21–2.43; P<.05). Positive expression of vascular endothelial growth factor, epidermal growth factor receptor, and p53 were: 8.5%, 58.7%, and 36.4%, respectively. In univariate analysis, vascular endothelial growth factor positivity was a significant predictor of overall survival (RR = 1.62; 95% CI, 0.99–2.42; P = .05). In multivariate analysis, positive vascular endothelial growth factor status maintained significant correlation with overall survival (RR, 2.79; 95% CI, 1.49–4.95; P = .002).CONCLUSIONS.Vascular endothelial growth factor positivity appeared to be a significant predictor of overall survival in a multivariate model. Further evaluation of vascular endothelial growth factor‐positive laryngeal cancers treated with primary XRT is warranted. Cancer 2007;109:566–573. © 2006 American Cancer Society.

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“…The 8 Table 4 Disease-free survival rates during the first 5 years after initial therapy and successful treatment of recurrences disease-and recurrence-free survival after radiotherapy only was 80% [1], 84% [4], 94.2% [33], 92% T 1α and 80% T 1β [3], and 91.8% 3-year survival in 41 glottic tumors [21]. In 246 T 1 -T 2 patients, the 5-year survival was 83% after radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

How often is total laryngectomy necessary for the treatment of T1 failures after radiotherapy or cordectomy?

Markou

Nikolaou

Nalbadian

et al. 2002

European Archives of Oto-Rhino-Laryngology

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Between 1992 and 1998, 547 patients (pts) with laryngeal SCC were diagnosed and treated in our department, 145 (27%) of whom presented with glottic tumors T1N0M0 (125 T1a and 20 T1b). Seventy-eight (54%) were treated surgically with cordectomy and 67 (46%) with radiotherapy. After a median follow-up time of 43 months, 22 (15.2%) of the 145 pts presented with recurrent disease. In more detail, 16 (13%) of the 125 T1a pts and 6 (30%) of the 20 T1b pts had recurrences. Among the 78 surgically treated patients only 4 (5%) had recurrence, while 18 (27%) of the radiotherapy group relapsed. The difference is statistically significant (log rank test, P = 0.0001 < 0.05). After salvage treatment, of the 67 pts of the radiotherapy group 57 (85%) remain disease-free, 49 (73%) retaining their larynx intact and 1 only having undergone cordectomy. Among the cordectomy group 75 (96%) pts remain disease-free with only 1 having had a total laryngectomy. Using the Kaplan-Meier method and calculating the disease-free survival regardless of salvage treatment, there is no doubt that surgical treatment statistically is more successful than radiotherapy (log rank test, P = 0.01 < 0.05). Analysis of parameters such as tumor differentiation and T1a or T1b staging, which indeed influence the overall recurrence rate, did not alter the favorable outcome after surgical treatment.

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Radiation therapy in early carcinoma of the glottic larynx T1NOMO

Cited by 16 publications

References 6 publications

BCCIP as a prognostic marker for radiotherapy of laryngeal cancer

BCCIP as a prognostic marker for radiotherapy of laryngeal cancer

Prognostic significance of vascular endothelial growth factor protein levels in T1‐2 N0 laryngeal cancer treated with primary radiation therapy

How often is total laryngectomy necessary for the treatment of T1 failures after radiotherapy or cordectomy?

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